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Garduño-Alanis A, Contreras-Manzano A, Salgado JC, Lamadrid-Figueroa H, Curi-Quinto K, Barquera S. A high density of ultra-processed food, alcohol & tobacco retail stores, and social inequalities are associated with higher mortality rates of non-communicable diseases in Mexican adults: 2005 to 2021. PLoS One 2024; 19:e0301387. [PMID: 38598474 PMCID: PMC11006154 DOI: 10.1371/journal.pone.0301387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Non-communicable diseases (NCDs) are the leading causes of mortality in Mexico. Factors contributing to NCDs-related deaths may vary across small geographic areas such as municipalities. We aimed to predict municipal-level factors associated with NCD mortality in Mexican adults from 2005 to 2021 using the small-area analysis (SSA) approach. METHODS We gathered data on population sociodemographic, access to healthcare services, and mortality records at the municipal-level from census and public institutions from 2005 to 2021. We identified municipal predictors of NCDs mortality rates (MR) using negative binomial regression models. RESULTS A total of 584,052 observations of Mexican adults were analyzed. The national expected NCDs MR per 100,000 inhabitants was 210.7 (95%CI: 196.1-226.7) in 2005 and increased to 322.4 (95%CI: 300.3-346.4) by 2021. Predictors of NCDs mortality (quintile 5 vs. quintile 1) included; indigeneity (IRR = 1.15, 95%CI: 1.12-1.19), poverty (IRR = 1.14, 95%CI: 1.13-1.15), affiliation with Mexican Social Security Institute (IRR = 1.11, 95%CI: 1.09-1.14), households with television (IRR = 1.14, 95%CI: 1.11-1.17), and high density of ultra-processed food, alcohol & tobacco retail stores (IRR = 1.15, 95%CI: 1.13-1.17). The greatest increases in MR were observed in municipalities from Oaxaca (>200% increments). CONCLUSION There was an overall increase in NCDs MR from 2005 to 2021, with a significant geographic variation among Mexican municipalities. The results of this study highlight the importance of identifying priority areas in the country that urgently require public policies focused on local factors associated with deaths from NCDs, such as the regulation of the ultra-processed food, alcohol & tobacco retail stores, and efforts to reduce social inequalities.
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Affiliation(s)
- Adriana Garduño-Alanis
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
- National Council of Humanities, Science and Technology, Mexico
- Autonomous University of the State of Mexico, Toluca, State of Mexico, Mexico
| | - Alejandra Contreras-Manzano
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
- National Council of Humanities, Science and Technology, Mexico
| | - Juan Carlos Salgado
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
- National Council of Humanities, Science and Technology, Mexico
| | - Héctor Lamadrid-Figueroa
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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Quevedo KL, Jáuregui A, Nieto C, Contreras-Manzano A, White CM, Vanderlee L, Barquera S, Corvalán C, Hammond D. Sociodemographic differences in nutrition labels effect on Chilean and Mexican youth. Rev Panam Salud Publica 2024; 48:e33. [PMID: 38576841 PMCID: PMC10993807 DOI: 10.26633/rpsp.2024.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/18/2023] [Indexed: 04/06/2024] Open
Abstract
Objective To examine sociodemographic differences in the awareness, understanding, use and effect of nutrition labels among Mexican and Chilean youth. Methods Online surveys among youth (10-17 years) were obtained in 2019 (n=2631). Participants reported their awareness, understanding, and use of their country-specific nutrition facts tables (NFT) and front-of-pack labels (FOPL) (Chile: warning labels [WLs]; Mexico: guideline daily amounts [GDA]). Additionally, participants reported their perceived healthfulness of a sweetened fruit drink after viewing one of six versions of it with different FOPL (no-label control, Health Star Rating, WLs, GDAs, Traffic Light, or Nutri-Score) during an experimental task. Results Higher self-reported nutrition knowledge was associated with higher NFT and FOPL awareness, understanding, and use, except for WL use. WLs were the most effective FOPL in decreasing the perceived healthfulness of the sweetened fruit drink compared to a no-label condition and other FOP labels. In Chile, the effect of GDA differed by income adequacy, while in Mexico Nutri-Score differed by age. Conclusions Results suggest that nutrition label awareness, use, understanding, and impact differ across demographics, favoring higher income and nutrition knowledge. Despite this, WLs are likely to have a positive impact on nutrition-related knowledge and behaviors among Mexican and Chilean youth, independently of their socio-demographic groups.
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Affiliation(s)
- Kathia Larissa Quevedo
- Instituto Nacional de Salud PúblicaCuernavacaMexicoInstituto Nacional de Salud Pública, Cuernavaca, Mexico.
| | - Alejandra Jáuregui
- Instituto Nacional de Salud PúblicaCuernavacaMexicoInstituto Nacional de Salud Pública, Cuernavaca, Mexico.
| | - Claudia Nieto
- Instituto Nacional de Salud PúblicaCuernavacaMexicoInstituto Nacional de Salud Pública, Cuernavaca, Mexico.
| | - Alejandra Contreras-Manzano
- Consejo Nacional de HumanidadesCiencias y TecnologíasMexico CityMexicoConsejo Nacional de Humanidades, Ciencias y Tecnologías, Mexico City, Mexico
| | - Christine M. White
- University of WaterlooWaterlooCanadaUniversity of Waterloo, Waterloo, Canada.
| | - Lana Vanderlee
- Université LavalQuebecCanadaUniversité Laval, Quebec, Canada
| | - Simón Barquera
- Instituto Nacional de Salud PúblicaCuernavacaMexicoInstituto Nacional de Salud Pública, Cuernavaca, Mexico.
| | - Camila Corvalán
- Universidad de ChileSantiagoChileUniversidad de Chile, Santiago, Chile
| | - David Hammond
- University of WaterlooWaterlooCanadaUniversity of Waterloo, Waterloo, Canada.
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Mendoza K, Villalobos-Daniel VE, Jáuregui A, Valero-Morales I, Hernández-Alcaraz C, Zacarías-Alejandro N, Alarcon-Guevara RO, Barquera S. Development of a crowdsourcing- and gamification-based mobile application to collect epidemiological information and promote healthy lifestyles in Mexico. Sci Rep 2024; 14:6174. [PMID: 38486091 PMCID: PMC10940696 DOI: 10.1038/s41598-024-56761-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 03/11/2024] [Indexed: 03/18/2024] Open
Abstract
We developed a mobile application to promote healthy lifestyles and collect non-communicable disease (NCD) data in Mexico. Its theoretical foundations are supported by a framework-guided literature review. With design sprints, Scrum, Model-View-Controller, and Representational State Transfer architecture, we operationalized evidence-based nutrition/physical activity information into a crowdsourcing- and gamification-based application. The application was piloted for three months to monitor the response of 520 adults. Potential improvements were characterized, considering benchmarking, expert guidance, and standards. Salud Activa (English: Active Health) has two crowdsourcing modules: Nutritional scanner, scanning products' bar codes, providing nutritional data, and allowing new product registry feeding our databases; Surveys, comprising gradually-released NCD questions. Three intervention modules were generated: Drinks diary, a beverage assessment component to receive hydration recommendations; Step counter, monitoring users' steps via Google Fit/Health-iOS; Metabolic Avatar, interconnecting modules and changing as a function of beverage and step records. The 3-month median of Salud Activa use was seven days (IQR = 3-12), up to 35% of participants completed a Survey section, and 157 food products were registered through Nutritional scanner. Better customization might benefit usability and user engagement. Quantitative and qualitative data will enhance Salud Activa's design, user uptake, and efficacy in interventions delivered through this platform.
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Affiliation(s)
- Kenny Mendoza
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
- Center for Nutrition and Health Research (CINyS), National Institute of Public Health (INSP), Cuernavaca, Morelos, Mexico
| | - Víctor Eduardo Villalobos-Daniel
- Center for Nutrition and Health Research (CINyS), National Institute of Public Health (INSP), Cuernavaca, Morelos, Mexico
- Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Alejandra Jáuregui
- Center for Nutrition and Health Research (CINyS), National Institute of Public Health (INSP), Cuernavaca, Morelos, Mexico
| | - Isabel Valero-Morales
- Center for Nutrition and Health Research (CINyS), National Institute of Public Health (INSP), Cuernavaca, Morelos, Mexico
- Queen Mary University of London, London, UK
| | - César Hernández-Alcaraz
- Center for Nutrition and Health Research (CINyS), National Institute of Public Health (INSP), Cuernavaca, Morelos, Mexico
| | | | - Ricardo Omar Alarcon-Guevara
- Center for Nutrition and Health Research (CINyS), National Institute of Public Health (INSP), Cuernavaca, Morelos, Mexico
| | - Simón Barquera
- Center for Nutrition and Health Research (CINyS), National Institute of Public Health (INSP), Cuernavaca, Morelos, Mexico.
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Rivera JA, Colchero MA, Pérez-Ferrer C, Barquera S. Perspective: Mexico's Experience in Building a Toolkit for Obesity and Noncommunicable Diseases Prevention. Adv Nutr 2024; 15:100180. [PMID: 38246349 PMCID: PMC10877686 DOI: 10.1016/j.advnut.2024.100180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/15/2023] [Accepted: 01/16/2024] [Indexed: 01/23/2024] Open
Abstract
Noncommunicable diseases (NCDs) are a leading cause of death and disability worldwide, with a higher risk of death in low- and middle-income countries. Diet and excess weight are risk factors for NCDs. In Mexico, the prevalence of overweight and obesity increased dramatically in the last 30 y and is among the highest in the world. To address this public health problem, governments and public health professionals have several policy instruments available. In this study, we present the policy instruments currently approved in Mexico, which include fiscal, informational, and authoritative tools that aim to improve the food environment and promote healthy behaviors (taxes, school food guidelines, front-of-pack labeling, marketing regulations, and dietary guidelines). These types of interventions are important in regions like Latin America, where social inequities and poor access to information are common, and individual healthy choices are often limited. These interventions target the environments in which individuals live, study, work, and seek entertainment, while limiting access to unhealthy choices and offering information to promote healthy alternatives. The Mexican experience in design, implementation, and evaluation of policies to improve the food environment can be useful for other low- and middle-income countries facing similar challenges.
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Affiliation(s)
- Juan A Rivera
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
| | - Mónica Arantxa Colchero
- Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Carolina Pérez-Ferrer
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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Tolentino-Mayo L, Durán R, Espinosa F, Ferré I, Munguía A, Barquera S. Análisis de los argumentos recibidos en la consulta pública para el etiquetado frontal de advertencia mexicano. Salud Publica Mex 2023; 66:67-77. [PMID: 38065116 DOI: 10.21149/14908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 09/07/2023] [Indexed: 12/18/2023] Open
Abstract
OBJETIVO Analizar los diferentes elementos en los argumentos recibidos durante la consulta pública del Proyecto de Modificación a la Norma Oficial Mexicana-051 (NOM-051), con énfasis en la protección de niñas, niños y adolescentes (NNA). Material y métodos. Se analizó la información de 1 095 argumentos, se identificó a los actores clave y se realizó un análisis de contenido para conocer la postura, a favor o en contra de los numerales relacionados con la protección a NNA. El análisis se hizo en el programa NVivo. RESULTADOS Se identificaron 781 actores clave. Durante la consulta pública se identificaron cuatro tácticas del sector privado para interferir en el proceso de la NOM-051: a) grupos fachada que enviaron comentarios en contra de la NOM-051; b) cuestionar la evidencia científica sobre la relación del consumo de edulcorantes y el desarrollo de obesidad en escolares; c) cuestionar la efectividad del uso del etiquetado de advertencia para edulcorantes; d) responsabilizar a los individuos de su enfermedad. Conclusión. La interferencia del sector privado en el proceso de implementación de la NOM-051 fue evidente en los argumentos enviados durante la consulta pública.
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Affiliation(s)
- Lizbeth Tolentino-Mayo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Regina Durán
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Fiorella Espinosa
- Fondo de las Naciones Unidas para la Infancia. Ciudad de México, México..
| | - Isabel Ferré
- Fondo de las Naciones Unidas para la Infancia. Ciudad de México, México..
| | - Ana Munguía
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
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Soares Guimarães J, Pauzé E, Potvin Kent M, Barquera S, Jáuregui A, Sacks G, Vanderlee L, Hammond D. The relationship between parent's self-reported exposure to food marketing and child and parental purchasing and consumption outcomes in five countries: findings from the International Food Policy Study. J Nutr Sci 2023; 12:e123. [PMID: 38155804 PMCID: PMC10753451 DOI: 10.1017/jns.2023.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 08/29/2023] [Accepted: 09/21/2023] [Indexed: 12/30/2023] Open
Abstract
Food and beverage marketing influences children's food preferences and dietary intake. Children's diets are also heavily influenced by their family environment. The aim of this study was to assess the relationship between parent's self-reported exposure to unhealthy food marketing and a range of outcomes related to children's desire for and intake of unhealthy foods and beverages. The study also sought to examine whether these outcomes varied across different countries. The analysed data are from the International Food Policy Study and were collected in 2018 using an online survey. The sample included 5764 parents of children under 18, living in Australia, Canada, Mexico, the United Kingdom, or the United States. Binary logistic regressions assessed the link between the number of parental exposure locations and children's requests for and parental purchases of unhealthy foods. Generalized ordinal regression gauged the relationship between the number of exposure locations and children's consumption of such items. Interaction terms tested if these associations varied by country. Parental exposure to unhealthy food marketing was positively associated with parents reporting child purchase requests and purchase outcomes; and differed by country. Increased parental exposure to unhealthy food marketing was associated with slightly lower odds of children's weekly consumption of unhealthy foods, and this association varied by country. In conclusion, parental report of a greater range of food marketing exposure was associated with a range of outcomes that would increase children's exposure to unhealthy food products or their marketing. Governments should consider developing more comprehensive restrictions on the marketing of unhealthy foods.
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Affiliation(s)
| | - Elise Pauzé
- School of Interdisciplinary Health Sciences, University of Ottawa, Ottawa, Canada
| | - Monique Potvin Kent
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Simón Barquera
- Center for Nutrition and Health Research, INSP, Cuernavaca, Mexico
| | | | - Gary Sacks
- School of Health and Social Development, Deakin University, Victoria, Australia
| | - Lana Vanderlee
- School of Nutrition, Université of Laval, Quebec City, Canada
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
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Arellano-Gómez LP, Jáuregui A, Nieto C, Contreras-Manzano A, Quevedo KL, White CM, Thrasher JF, Davis RE, Hammond D, Barquera S. Effects of front-of-package caffeine and sweetener disclaimers in Mexico: cross-sectional results from the 2020 International Food Policy Study. Public Health Nutr 2023; 26:3278-3290. [PMID: 37781769 PMCID: PMC10755452 DOI: 10.1017/s1368980023002100] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 08/12/2023] [Accepted: 09/07/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE Front-of-package warning labels introduced in Mexico in 2020 included disclaimers that caution against allowing children to consume products with non-sugary sweeteners and caffeine. We examined the awareness and use of the disclaimers among Mexican adults and youth 1 month after the regulation was implemented. We also investigated their impact on the perceived healthfulness of industrialised beverages designed for children. DESIGN Data on the awareness and use of the disclaimers were analysed. Two between-subjects experiments examined the effect of a sweetener disclaimer (Experiment 1, youth and adults) or a caffeine disclaimer (Experiment 2, only adults) on the perceived healthfulness of industrialised beverages. Interactions between experimental conditions and demographic characteristics were tested. SETTING Online survey in 2020. PARTICIPANTS Mexican adults (≥18 years, n 2108) and youth (10-17 years, n 1790). RESULTS Most participants (>80 %) had seen the disclaimers at least rarely, and over 60 % used them sometimes or frequently. The sweetener disclaimer led to a lower perceived healthfulness of a fruit drink (adults: 2·74 ± 1·44; youth: 2·04 ± 0·96) compared with the no-disclaimer condition (adults: 3·17 ± 1·54; youth: 2·32 ± 0·96) (t's: >4·0, P values: <0·001). This effect was larger among older adults and male youth. The caffeine disclaimer did not affect adult's perceived healthfulness of a caffeinated drink (t = 0·861, P value = 0·3894). CONCLUSIONS There were high awareness and use of the sweeteners and caffeine disclaimers shortly after the warning labels were implemented. The sweetener disclaimer appears to be helping consumers modify their perceptions regarding industrialised beverages for children. Findings may help decision-makers improve the regulation and better target communication strategies.
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Affiliation(s)
- Laura Patricia Arellano-Gómez
- Center for Research on Nutrition and Health, Instituto Nacional de Salud Pública, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca, 62100, Mexico
- Department of Psychology, Education and Health, Nutrition and Food Sciences, ITESO Jesuit University of Guadalajara, Guadalajara, Mexico
| | - Alejandra Jáuregui
- Center for Research on Nutrition and Health, Instituto Nacional de Salud Pública, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca, 62100, Mexico
| | - Claudia Nieto
- Center for Research on Nutrition and Health, Instituto Nacional de Salud Pública, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca, 62100, Mexico
| | - Alejandra Contreras-Manzano
- Center for Research on Nutrition and Health, Instituto Nacional de Salud Pública, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca, 62100, Mexico
- National Council for Science and Technology (CONACYT), Mexico City, Mexico
| | - Kathia Larissa Quevedo
- Center for Research on Nutrition and Health, Instituto Nacional de Salud Pública, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca, 62100, Mexico
| | - Christine M White
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - James F Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, USA
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Rachel E Davis
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, USA
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Simón Barquera
- Center for Research on Nutrition and Health, Instituto Nacional de Salud Pública, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca, 62100, Mexico
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Contreras-Manzano A, White CM, Nieto C, Quevedo KL, Vargas-Meza J, Hammond D, Thrasher JF, Barquera S, Jáuregui A. Self-reported decreases in the purchases of selected unhealthy foods resulting from the implementation of warning labels in Mexican youth and adult population. medRxiv 2023:2023.11.22.23298843. [PMID: 38045333 PMCID: PMC10690347 DOI: 10.1101/2023.11.22.23298843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Background Front-of-package nutritional warning labels (WLs) are designed to facilitate identification and selection of healthier food choices. We assessed self-reported changes in purchasing different types of unhealthy foods due to WLs in Mexico and the association between the self-reported reductions in purchases of sugary beverages and intake of water and sugar-sweetened beverages. Methods Data came from 14-17 year old youth (n=1,696) and adults ≥18 (n=7,775) who participated in the Mexican arm of the 2020-2021 International Food Policy Study, an annual repeat cross-sectional online survey. Participants self-reported whether the WLs had influenced them to purchase less of each of ten unhealthy food categories due to WLs. Among adults, a 23-item Beverage Frequency Questionnaire was used derive past 7-day intake of water and sugary beverages analyzed to determine the relationship between self-reported reductions in purchasing sugary drinks due to the WLs. Multilevel mixed-effects logistic regression models were fitted to estimate the percentage of participants who self-reported reducing purchases within each food group, and overall. Sociodemographic characteristics associated with this reduction were investigated as well. Results Overall, 44.8% of adults and 38.7% of youth reported buying less of unhealthy food categories due to the implementation of WL, with the largest proportion reporting decreased purchases of cola, regular and diet soda. A greater impact of WLs on the reported purchase of unhealthy foods was observed among the following socio-demographic characteristics: females, individuals who self-identified as indigenous, those who were overweight, individuals with lower educational levels, those with higher nutrition knowledge, households with children, and those with a significant role in household food purchases. In addition, adults who reported higher water intake and lower consumption of sugary beverages were more likely to report reduced purchases of sugary drinks due to the WLs. Adults who reported greater water intake and lower sugary beverages intake were significantly more likely to report buying fewer sugary drinks due to the WLs. Conclusion Our findings suggest that implementation of WLs has reduced purchases of unhealthy foods in Mexico. These results underscore the positive impact of the labeling policy particularly in subpopulations with lower levels of education and among indigenous adults.
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Medina C, Jáuregui A, Hernández C, González C, Blas N, Campos I, Barquera S. Factores asociados con el cumplimiento de los comportamientos del movimiento en adultos mexicanos: Ensanut 2022. Salud Publica Mex 2023; 65:674-684. [PMID: 38060924 DOI: 10.21149/15204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/09/2023] [Indexed: 12/18/2023] Open
Abstract
OBJETIVO Examinar las características sociodemográficas e indicadores de salud asociados con el cumplimiento de las recomendaciones de los comportamientos del movimiento en adultos mexicanos. Material y métodos. Estudio transversal que utilizó datos de la Encuesta Nacional de Salud y Nutrición (Ensanut) 2022. Se obtuvo información de actividad física (AF), sedentarismo y sueño, características sociodemográficas e indicadores de salud en adultos de 20-78 años. Para el análisis se utilizaron regresiones logísticas y lineales ajustadas y no por covariables. RESULTADOS Los adultos que viven en áreas urbanas tuvieron mayor posibilidad de no cumplir las recomendaciones de actividad física, sedentarismo, sueño y los comportamientos del movimiento (CM) en conjunto. No cumplir las recomendaciones de los tres CM se asoció con mayores niveles de glucosa, colesterol y tensión arterial elevada. Conclusión. La asociación de los CM con indicadores de salud muestra la importancia de identificar estrategias para promover estos comportamientos en la población mexicana.
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Affiliation(s)
- Catalina Medina
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Alejandra Jáuregui
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - César Hernández
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Citlali González
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Nabetse Blas
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Ismael Campos
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
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Villaverde P, Tolentino-Mayo L, Cruz-Casarrubias C, Salgado JC, Aburto TC, Barquera S. Hypothetical impact of the Mexican front-of-pack labeling on intake of critical nutrients and energy. J Health Popul Nutr 2023; 42:124. [PMID: 37941048 PMCID: PMC10631037 DOI: 10.1186/s41043-023-00462-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 10/27/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Since 2020 in Mexico, front-of-pack warning labels (FOPWL) have been implemented in processed products. Evidence supports warning labels allow consumers to identify unhealthy products. We aimed to evaluate the hypothetical impact of the FOPWL regulation on the Mexican population's intake of critical nutrients and energy, based on the replacement of food and beverages using 4 hypothetical scenarios which represented the phases of the regulation. METHODS Dietary data were collected using a standardized 24-h dietary recall from the 2016 Mexican National Health and Nutrition Survey (n = 4184). To evaluate the hypothetical impact of FOPWL, the nutritional content of critical nutrients in processed products was evaluated according to the Mexican Official Standard 051 (NOM-051). Then, we replaced products with several warning labels (WL) with those with a fewer number of them or with non-processed food. For the replacement, 4 hypothetical scenarios were established: scenario 1: the current consumption of the Mexican Population, scenario 2: the replacement during the first phase of the norm, scenario 3: the replacement in the second phase and scenario 4: the replacement in the last phase. We estimated the means, confidence intervals (CI 95%), and the mean percentage change of energy, saturated fat, trans-fat, added sugars, and sodium intake during the second, third, and the fourth scenarios. RESULTS According to the norm, in the second scenario, the majority of the products presented a label for energy (52.6%) whereas in the third (56.4%) and fourth (61.2%) scenarios were for sodium. In contrast, trans-fat was the least labeled nutrient in all the scenarios (from 2.1 to 4.1%). In the fourth scenario, we observed a reduction of the intake of energy intake to 15.4% as well as saturated fat (- 20%, CI 95% - 18.4; - 21.6), trans-fat (- 8.2%, CI 95% - 6.4; - 10.1) and sodium (- 12.7%, CI 95% - 11.3; - 14.1). The most important reduction was observed for added sugars intake (until - 54.1%, CI 95% - 51; - 57.1). CONCLUSIONS FOPWL could be an effective strategy to decrease energy consumption and nutrients of concern. If consumers use the FOPWL, it would be an important change in critical nutrients intake. These results support that FOPWL might help the Mexican population to choose healthier nutrition alternatives.
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Affiliation(s)
- Paola Villaverde
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Lizbeth Tolentino-Mayo
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico.
| | - Carlos Cruz-Casarrubias
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Juan C Salgado
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
- National Council of Humanities, Science and Technology, Mexico. Av. de los Insurgentes Sur 1582, Crédito Constructor, Benito Juárez, 03940, Mexico City, CDMX, Mexico
| | - Tania C Aburto
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
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11
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Quevedo KL, Jáuregui A, Nieto C, Ortiz-Panozo E, Contreras-Manzano A, Barquera S, Vanderlee L, White CM, Hammond D. Public support for food policies in Mexican adults: Findings from the International Food Policy Study, 2017-2021. Prev Med 2023; 175:107710. [PMID: 37775082 PMCID: PMC10644906 DOI: 10.1016/j.ypmed.2023.107710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/01/2023] [Accepted: 09/21/2023] [Indexed: 10/01/2023]
Abstract
Deaths attributable to unhealthful eating underscore the need to improve dietary patterns through upstream, policy-led solutions. The approval and successful implementation of food policies is partly determined by their public acceptance. Little is known about public support for food policies in Mexico. We aimed to investigate the level of public support for 30 food policies, grouped into 5 domains, and their associated characteristics among Mexican adults. Data are from the 2017-2021 International Food Policy Study (IFPS), a cross-sectional web-based survey of adults. Differences in public support across years were estimated using linear regression models. The association between demographic characteristics and policy support was analyzed using multivariate logistic regression models. The highest mean support was for the subsidies and benefits domain, followed by the labelling and reformulation domain. The level of support varied across years and policy domains. Support was higher in 2019 compared to 2017 and 2018, and subsequently lower in 2020 and 2021 compared to previous years. Older age was associated with greater support across all domains (OR ranged from 0.002 to 0.004, p < 0.01). Female participants and those selfidentifying as indigenous showed greater support for certain policy domains, whereas higher income adequacy was associated with lower support for other policy domains. In Mexico, support for food policies varies across subpopulations. Our findings may serve as a guide to the development and promotion of food policies in Mexico, as well as to improve their feasibility and success.
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Affiliation(s)
- Kathia Larissa Quevedo
- Center for Nutrition and Health Research, National Institute of Public Health, 655 University Avenue, Santa María Ahuacatitlan, 62100 Cuernavaca, Morelos, Mexico.
| | - Alejandra Jáuregui
- Center for Nutrition and Health Research, National Institute of Public Health, 655 University Avenue, Santa María Ahuacatitlan, 62100 Cuernavaca, Morelos, Mexico.
| | - Claudia Nieto
- Center for Nutrition and Health Research, National Institute of Public Health, 655 University Avenue, Santa María Ahuacatitlan, 62100 Cuernavaca, Morelos, Mexico.
| | - Eduardo Ortiz-Panozo
- Center for Population Health Research, National Institute of Public Health, 655 University Avenue, Santa María Ahuacatitlan, 62100 Cuernavaca, Morelos, Mexico.
| | - Alejandra Contreras-Manzano
- Center for Nutrition and Health Research, National Institute of Public Health, 655 University Avenue, Santa María Ahuacatitlan, 62100 Cuernavaca, Morelos, Mexico; National Council for Humanities, Science and Technology, 1528 de los Insurgentes Avenue, Crédito Constructor, Benito Juárez 03940, Mexico City, Mexico.
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, 655 University Avenue, Santa María Ahuacatitlan, 62100 Cuernavaca, Morelos, Mexico.
| | - Lana Vanderlee
- School of Nutrition, Université Laval, 2440 boulevard Hochelaga, Quebec, QC G1V 0A6, Canada.
| | - Christine M White
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada.
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada.
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12
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Aburto TC, Romieu I, Stern MC, Barquera S, Corvalán C, Hallal PC, Reynales-Shigematsu LM, Barnoya J, Cavalcante TM, Canelo-Aybar C, Santero M, Feliu A, Espina C, Rivera JA. Latin American and the Caribbean Code Against Cancer 1st edition: Weight, physical activity, diet, breastfeeding, and cancer. Cancer Epidemiol 2023; 86 Suppl 1:102436. [PMID: 37852731 DOI: 10.1016/j.canep.2023.102436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/06/2023] [Accepted: 07/13/2023] [Indexed: 10/20/2023]
Abstract
In Latin America and the Caribbean a considerable proportion of the population have excess body weight, do not meet the recommendations of physical activity and healthy diet, and have suboptimal rates of breastfeeding. Excess body weight is associated with at least 15 cancer sites, physical activity protects against three cancers, with some evidence suggesting a protective effect for eight more cancer sites, and sedentary behavior probably increases the risk of five cancer sites. Fiber and wholegrains protect against colorectal cancer, high intake of fruits and vegetables could reduce the risk of aerodigestive cancers; processed and red meat increase the risk of colorectal cancer; and very hot beverages are associated with esophageal cancer. Moreover, sugar-sweetened beverages and ultra-processed foods are a convincing cause for excess body weight, increasing cancer risk through this pathway, with some emerging evidence suggesting also direct pathways. Breastfeeding protects against breast cancer, and could protect against ovarian cancer. Taking this evidence into account, the Latin America and the Caribbean Code Against Cancer recommends the general public to maintain a healthy body weight, be physically active and limit sedentary behavior, eat a healthy diet (eat plenty of vegetables, fruits, wholegrains and legumes; avoid sugar-sweetened beverages and processed meat; and limit ultra-processed foods, red meat and very hot beverages), and breastfeed. Moreover, the Latin America and the Caribbean Code Against Cancer also includes a set of public policy recommendations for cancer prevention to inform policy makers and civil society about the need of policies to shape healthy environments and create opportunities to facilitate the adoption of the recommendations directed to the public.
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Affiliation(s)
- Tania C Aburto
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Isabelle Romieu
- Center for Population Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Mariana C Stern
- Department of Preventive Medicine and Urology, Keck School of Medicine of USC, 90033 Los Angeles, United States
| | - Simón Barquera
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Camila Corvalán
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Pedro C Hallal
- Department of Kinesiology and Community Health, University of Illinois Champaign-Urbana, Illinois, United States
| | - Luz M Reynales-Shigematsu
- Center for Population Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Joaquín Barnoya
- Research Department, Integra Cancer Institute, Guatemala City, Guatemala; Department of Environmental and Occupational Health, Colorado School of Public Health, CU Anschutz, United States
| | - Tania M Cavalcante
- Instituto Nacional de Câncer José de Alencar Gomes da Silva, Secretaria Executiva da Comissão Nacional para a Implementação da Convenção-Quadro para o Controle do Tabaco, Rio de Janeiro, RJ, Brasil
| | - Carlos Canelo-Aybar
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Marilina Santero
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Ariadna Feliu
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07 France
| | - Carolina Espina
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07 France
| | - Juan A Rivera
- Center for Population Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico.
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13
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Carriedo A, Cairney P, Barquera S, Hawkins B. Policy networks and competing interests in the development of the Mexican sugar-sweetened beverages tax. BMJ Glob Health 2023; 8:e012125. [PMID: 37813438 PMCID: PMC10565318 DOI: 10.1136/bmjgh-2023-012125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/05/2023] [Indexed: 10/13/2023] Open
Abstract
INTRODUCTION Sugar taxes threaten the business models and profits of the food and beverage industry (F&BI), which has sought to avert, delay or influence the content of health taxes globally. Mexico introduced a sugar-sweetened beverage (SSB) tax in 2014 and other regulatory measures to improve population diets. This paper examines how policy networks emerged within and affected the development and implementation of the Mexican SSB tax. METHODS This qualitative study analyses 31 interviews conducted with key stakeholders involved in the soda tax policy process and 145 documents, including grey literature and peer-reviewed literature. The policy network approach was used to map contacts, interconnections, relationships and links between the state, civil society and commercial actors involved in the SSB tax. These findings were used to examine the responsiveness, participation and accountability of the soda tax policy formulation. RESULTS Complex interconnections were identified between state and non-state actors. These included advisory relationships, financial collaborations and personal connections between those in high-level positions. Relationships between the government and the F&BI were not always disclosed. International organisations and academics were identified as key financial or technical supporters of the tax. Key governance principles of participation, responsiveness and accountability were undermined by some of these relationships, including the participation of non-state actors in policy development and the powerful role of the F&BI in evaluation and monitoring. CONCLUSION This case study exemplifies the importance of links and networks between actors in health policymaking. The F&BI influence endangers the primary aim of the SSB tax to protect health. The identified links highlight the normalisation of connections among actors with competing aims and interests toward health, thereby jeopardising attempts to tackle obesity rates.
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Affiliation(s)
| | - Paul Cairney
- Division of History, Heritage, and Politics, University of Stirling, Stirling, UK
| | - Simón Barquera
- Centre of Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Benjamin Hawkins
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
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14
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Reynales-Shigematsu LM, Barnoya J, Cavalcante T, Aburto TC, Romieu I, Stern MC, Barquera S, Corvalán C, Hallal PC, Canelo-Aybar C, Alvarado-Villacorta R, Espina C, Feliu A, Rivera JA. Latin America and the Caribbean Code Against Cancer 1st edition: Tobacco and nicotine-related products, secondhand smoke, and alcohol and cancer. Cancer Epidemiol 2023; 86 Suppl 1:102413. [PMID: 37852726 DOI: 10.1016/j.canep.2023.102413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/27/2023] [Accepted: 06/30/2023] [Indexed: 10/20/2023]
Abstract
Tobacco, secondhand smoke (SHS), and alcohol, all carcinogens, are leading preventable cancer risk factors in Latin America and the Caribbean (LAC). Since 2000, smoking and SHS exposure have significantly decreased in the region. Yet alcohol consumption remains high. The entry of nicotine-related products such as electronic cigarettes (e-cigs) threatens achievements made in tobacco control and chronic diseases prevention, including cancer. E-cigs use is likely associated with smoking initiation among adolescents who had never smoked and dual use with combustible tobacco products. Therefore, the LAC Code Against Cancer recommends to the public actions they can take to reduce their risk of cancer: 1. Don't smoke or use any type of tobacco. If you do, quitting is possible, with professional help if needed. Don't use e-cigarettes either, as they lead to tobacco use. 2. Make your home a smoke-free place. Respect and promote laws that ensure smoke-free spaces to protect our health. and 3. Avoid drinking alcoholic beverages. This helps prevent several types of cancer. The Code recommends to policymakers a package of cost-effective policies based on the MPOWER and SAFER to prevent cancer at the population level. It also recommends that primary care health professionals: 1. Ask all their patients and their families whether they smoke or vape, inform them about the harms of smoking and vaping, and promote tobacco and nicotine related products cessation strategies among users. 2. Inform about the harms of exposure to SHS, especially among children, and promote smoke-free environments, and 3. Prevent alcohol use by their patients and their families, use tools to assess use, intensity, and frequency, and apply brief counseling intervention to support alcohol abstinence in primary care.
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Affiliation(s)
- Luz Myriam Reynales-Shigematsu
- Tobacco Control and Preventive Department. Center for Population Health Research. National Institute of Public Health. Av. Universidad 655, Col. Santa María Ahuacatitlán, Cuernavaca, Morelos CP 62100, Mexico.
| | - Joaquin Barnoya
- Integra Cancer Institute, Guatemala, 9ª calle 4-52 zona 10, Guatemala, Guatemala
| | - Tania Cavalcante
- Instituto Nacional del Cáncer, INCA, Brasil.Pr. da Cruz Vermelha, 23 - Centro, Rio de Janeiro, RJ 20230-130, Brazil
| | - Tania C Aburto
- Center for Research on Nutrition and Health, National Institute of Public Health, CP 62100 Cuernavaca, Mexico
| | - Isabelle Romieu
- Center for Population Health Research, National Institute of Public Health, CP 62100, Cuernavaca, Mexico
| | - Mariana C Stern
- Department of Preventive Medicine and Urology, Keck School of Medicine of USC, 90033 Los Angeles, USA
| | - Simón Barquera
- Center for Research on Nutrition and Health, National Institute of Public Health, CP 62100 Cuernavaca, Mexico
| | - Camila Corvalán
- Institute of Nutrition and Food Technology (INTA), University of Chile, Macul, Chile
| | - Pedro C Hallal
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, United States
| | - Carlos Canelo-Aybar
- Department of Clinical Epidemiology and Public Health, Iberossssamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Rosa Alvarado-Villacorta
- Department of Clinical Epidemiology and Public Health, Iberossssamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Carolina Espina
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07, France
| | - Ariadna Feliu
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07, France
| | - Juan A Rivera
- Center for Population Health Research, National Institute of Public Health, CP 62100, Cuernavaca, Mexico
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15
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Vargas-Meza J, Gonzalez-Rocha A, Campos-Nonato I, Nilson EAF, Basto-Abreu A, Barquera S, Denova-Gutiérrez E. Effective and Scalable Interventions to Reduce Sodium Intake: a Systematic Review and Meta-Analysis. Curr Nutr Rep 2023; 12:486-494. [PMID: 37226030 DOI: 10.1007/s13668-023-00477-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2023] [Indexed: 05/26/2023]
Abstract
PURPOSE OF REVIEW High-sodium intake is a main risk factor for increased blood pressure and cardiovascular disease, the leading cause of death worldwide. Reducing sodium intake at the population level is one of the most cost-effective strategies to address this. The aim of the present systematic review and meta-analysis are to examine data from recent studies that measure the effectiveness and scalability of interventions aimed at reducing sodium intake at both the population and individual level. RECENT FINDINGS Worldwide, sodium intake is higher than the World Health Organization recommendations. Structural interventions such as mandatory reformulation of foods, food labeling, taxes or subsidies, and communication campaigns have shown to be the most effective in reducing the population's sodium consumption. Interventions in education, particularly those that use a social marketing framework with short duration, food reformulation, and combined strategies, have the potential to decrease sodium intake.
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Affiliation(s)
- Jorge Vargas-Meza
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Avenida Universidad #655, Cuernavaca, México
- El Poder del Consumidor A.C., Ciudad de México, México
| | - Alejandra Gonzalez-Rocha
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Avenida Universidad #655, Cuernavaca, México
| | - Ismael Campos-Nonato
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Avenida Universidad #655, Cuernavaca, México
| | - Eduardo Augusto Fernandes Nilson
- Nucleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brasil
- Programa de Alimentação, Nutrição e Cultura, Oswaldo Cruz Foundation (Fiocruz), Brasilia, Brazil
| | - Ana Basto-Abreu
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Avenida Universidad #655, Cuernavaca, México
| | - Edgar Denova-Gutiérrez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Avenida Universidad #655, Cuernavaca, México.
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Martínez-Duncker R D, Urzúa-González AR, Aguilera-Mora LF, Laínez-Zelaya JS, Álvarez de la Cadena-Sillas J, Celaya-Cota MDJ, González-Cruz EH, Delgado E, Campos-Nonato I, Denova-Gutiérrez E, Cruz-Valdez A, Cossio-Aranda JE, Guerra-López A, Enciso-Muñoz JM, Sánchez-Arreola LD, Magaña-Serrano JA, Díaz-Aguilera MÁ, Gómez-Álvarez E, Oseguera-Moguel J, Barquera S, Sifuentes-Osornio J, Lazcano Ponce EC. Espacios cardioprotegidos en México: acciones para prevenir la muerte súbita cardiaca. Una postura de profesionales de la salud. Salud Publica Mex 2023; 65:407-415. [PMID: 38060893 DOI: 10.21149/14698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/19/2023] [Indexed: 12/18/2023] Open
Abstract
La muerte súbita cardiaca es un problema de salud pública a nivel mundial. Aunque su incidencia no es conocida, se estima que causa hasta 50% de la mortalidad de origen cardíaco y hasta 20% de la mortalidad total en los adultos. En México, estimaciones previas sugieren que causa en promedio 33 000 muertes al año; sin embargo, los datos no son precisos. La mitad de los eventos por muerte súbita cardiaca se deben a un paro cardiaco súbito extrahospitalario que, de no ser atendido oportunamente, deriva en una muerte súbita cardiaca. Por tanto, la capacidad de responder pronta y adecuadamente a estos eventos con las maniobras y equipos necesarios mejora la sobrevida de las víctimas. Para atender este problema, en algunos estados del país se han creado espacios cardioprotegidos que permiten realizar maniobras de reanimación cardiopulmonar y desfibrilación cardiaca de acceso público oportunamente. Como objetivo, los profesionales de la salud establecen la importancia de implementar espacios cardioprotegidos y crear políticas públicas al respecto en todo el país.
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Affiliation(s)
| | | | | | - José S Laínez-Zelaya
- Servicio de Cardiología, Hospital de Alta Especialidad Centenario de la Revolución Mexicana, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado. Emiliano Zapata, Morelos, México..
| | | | | | - Erik H González-Cruz
- Instituto de Medicina del Deporte del Estado de Morelos, S.C. Cuernavaca, Morelos, México..
| | - Elisa Delgado
- Instituto de Medicina del Deporte del Estado de Morelos, S.C. Cuernavaca, Morelos, México..
| | - Ismael Campos-Nonato
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Edgar Denova-Gutiérrez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Aurelio Cruz-Valdez
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | | | | | - José Manuel Enciso-Muñoz
- Asociación Mexicana para la Prevención de la Aterosclerosis y sus Complicaciones. Ciudad de México, México..
| | | | | | - Miguel Ángel Díaz-Aguilera
- Centro Nacional de Programas Preventivos y de Control de Enfermedades, Secretaría de Salud. Ciudad de México, México..
| | - Enrique Gómez-Álvarez
- Departamento de Cardiología, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado. Ciudad de México, México..
| | - Jorge Oseguera-Moguel
- Departamento de Cardiología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México, México..
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - José Sifuentes-Osornio
- Dirección General, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México, México..
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García A, Valero-Morales I, Valbuena-Gregorio E, Olivas-Aguirre FJ, Tolentino-Mayo L, Barquera S, Nieto C. Mensajes persuasivos en redes sociales de la industria de alimentos y bebidas no saludables. Salud Publica Mex 2023; 65:377-386. [PMID: 38060905 DOI: 10.21149/14308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 06/02/2023] [Indexed: 12/18/2023] Open
Abstract
OBJETIVO Identificar los mensajes persuasivos usados por la industria de alimentos y bebidas no saludables en las redes sociales más visitadas por niñas, niños y adolescentes mexicanos y determinar a qué grupo de edad estaban dirigidos. Material y métodos. Se analizaron 892 anuncios de los 20 productos y marcas de alimentos y bebidas no saludables más consumidas en México publicados en las cuentas oficiales de dichos productos y marcas en YouTube, Facebook e Instagram. Se determinó el mensaje primario y el público objetivo (niños, adolescentes o ambos) y se clasificó como emocional o racional. RESULTADOS En Facebook, la proporción de anuncios con mensajes emocionales (50.7%) y mensajes racionales (49.3%) fue similar. En YouTube hubo mayor proporción de mensajes racionales (60.2%). Se encontraron 2.9 más posibilidades de que un mensaje persuasivo emocional se dirija a niños o adolescentes en comparación con mensajes que no tienen publicidad dirigida. Conclusión. La naturaleza de los mensajes persuasivos analizados depende de la red social en la que se presentaron. La industria alimentaria dirige sus mensajes a niños o adolescentes, razón por la que es importante regular la publicidad de alimentos y bebidas no saludables en redes sociales que busca influir en el comportamiento y las decisiones de compra de niñas, niños y adolescentes.
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Affiliation(s)
- Abad García
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Isabel Valero-Morales
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | | | | | - Lizbeth Tolentino-Mayo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Claudia Nieto
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
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18
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Campos-Nonato I, Oviedo-Solís C, Vargas-Meza J, Ramírez-Villalobos D, Medina-García C, Gómez-Álvarez E, Hernández-Barrera L, Barquera S. Prevalencia, tratamiento y control de la hipertensión arterial en adultos mexicanos: resultados de la Ensanut 2022. Salud Publica Mex 2023; 65:s169-s180. [PMID: 38060966 DOI: 10.21149/14779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/16/2023] [Indexed: 12/18/2023] Open
Abstract
OBJETIVO Describir la prevalencia de hipertensión arterial (HTA), las características del tratamiento y la proporción de adultos mexicanos que tiene tensión arterial (TA) controlada. Material y métodos. Se midió la TA a 8 647 adultos en la Encuesta Nacional de Salud y Nutrición 2022 (Ensanut 2022). Se consideró que un participante tenía HTA o TA controlada cuando cumplía los criterios de la American College of Cardiology y la American Heart Association (ACC/AHA) o la Eighth Joint National Committee (JNC-8). RESULTADOS La prevalencia de HTA en adultos fue 47.8% (según criterio del ACC/AHA). De éstos, 65.5% desconocía su diagnóstico. En adultos con diagnóstico previo de HTA, 33.7% tuvo TA controlada. Según la clasificación JNC-8, 29.4% de los adultos tenía HTA y 43.9% ignoraba su diagnóstico. Conclusión. En la Ensanut 2022 la mitad de los adultos tenía HTA y de ellos, tres de cada cinco no habían sido diagnosticados. El sistema de salud debe mejorar sus mecanismos de detección de HTA porque el subdiagnóstico y el mal control de la TA ocasiona discapacidad, mala calidad de vida y mortalidad prematura.
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Affiliation(s)
- Ismael Campos-Nonato
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca Morelos, México..
| | - Cecilia Oviedo-Solís
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca Morelos, México..
| | - Jorge Vargas-Meza
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca Morelos, México..
| | - Dolores Ramírez-Villalobos
- Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública. Cuernavaca Morelos, México..
| | - Catalina Medina-García
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca Morelos, México..
| | - Enrique Gómez-Álvarez
- Jefatura de División de Cardiocirugía, Centro Médico Nacional 20 de Noviembre. Ciudad de México, México..
| | - Lucía Hernández-Barrera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca Morelos, México..
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca Morelos, México..
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19
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Campos-Nonato I, Galván-Valencia Ó, Hernández-Barrera L, Oviedo-Solís C, Barquera S. Prevalencia de obesidad y factores de riesgo asociados en adultos mexicanos: resultados de la Ensanut 2022. Salud Publica Mex 2023; 65:s238-s247. [PMID: 38060949 DOI: 10.21149/14809] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/03/2023] [Indexed: 12/18/2023] Open
Abstract
OBJETIVO Describir la prevalencia de obesidad en adultos, medida a través del índice de masa corporal (IMC) y la circunferencia de cintura (CC), estratificando por factores de riesgo y comorbilidades. Material y métodos. Se analizó la información de 8 563 participantes en la Encuesta Nacional de Salud y Nutrición 2022 (Ensanut 2022). Se clasificó la obesidad por IMC y por CC. Se calcularon razones de momios (RM) para asociar la obesidad con factores de riesgo y diagnóstico de comorbilidades. RESULTADOS La prevalencia de sobrepeso fue 38.3%, obesidad 36.9% y obesidad abdominal (OA) 81.0%. Las mujeres tuvieron una mayor RM (1.4) de tener obesidad y OA (2.5). Los adultos con obesidad tenían una mayor posibilidad de tener diagnóstico de diabetes (RM 1.7), hipertensión (3.6) y dislipidemia (RM 2.3) que los adultos con IMC normal. CONCLUSIONES La prevalencia de obesidad en adultos mexicanos es una de las más altas a nivel mundial y está asociada con los factores de riesgo y enfermedades crónicas más frecuentes. Se requieren políticas públicas multisectoriales para prevenir y controlar la obesidad.
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Affiliation(s)
- Ismael Campos-Nonato
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Óscar Galván-Valencia
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Lucía Hernández-Barrera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Cecilia Oviedo-Solís
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
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20
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Medina C, Jáuregui A, Hernández C, González C, G Olvera A, Blas N, Campos I, Barquera S. Prevalencia de comportamientos del movimiento en población mexicana. Salud Publica Mex 2023; 65:s259-s267. [PMID: 38060964 DOI: 10.21149/14754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 04/20/2023] [Indexed: 12/18/2023] Open
Abstract
OBJETIVO Describir la prevalencia de los comportamientos del movimiento (CM) en 24 horas en población mexicana. Material y métodos. Se recolectó información de actividad física (AF), tiempo sedentario y sueño para individuos de 10 a 78 años por medio de la Encuesta Nacional de Salud y Nutrición 2022 (Ensanut 2022). RESULTADOS Más de 65% de niños y niñas no cumple con las recomendaciones de AF y pasan >2 horas/día frente a pantallas. Casi 91% de los adolescentes pasan >2 horas/día frente a pantalla. Más de 30% de los adolescentes y adultos no cumple con las recomendaciones de sueño. Sólo 1.5% de niños y niñas, 4.7% de adolescentes, 4.0% de los adultos y 1.5% de adultos mayores cumplieron las recomendaciones de los tres CM. Conclusión. Se evidencia la necesidad de desarrollar estrategias para contrarrestar la inactividad física, el comportamiento sedentario y el sueño insuficiente desde temprana edad hasta la adultez en población mexicana.
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Affiliation(s)
- Catalina Medina
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Alejandra Jáuregui
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - César Hernández
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Citlali González
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Armando G Olvera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Nabetse Blas
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Ismael Campos
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
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21
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Basto-Abreu A, López-Olmedo N, Rojas-Martínez R, Aguilar-Salinas CA, Moreno-Banda GL, Carnalla M, Rivera JA, Romero-Martinez M, Barquera S, Barrientos-Gutiérrez T. Prevalencia de prediabetes y diabetes en México: Ensanut 2022. Salud Publica Mex 2023; 65:s163-s168. [PMID: 38060942 DOI: 10.21149/14832] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 04/26/2023] [Indexed: 12/18/2023] Open
Abstract
OBJETIVO Estimar la prevalencia de prediabetes y diabetes en la población adulta mexicana. Material y métodos. Se utilizó información de la submuestra de adultos de la Encuesta Nacional de Salud y Nutrición 2022 con una muestra de sangre de 10 ml. Se excluyeron 150 individuos con ayuno menor a 8 horas y cuatro personas con diabetes gestacional. La muestra final fue de 1 945 adultos que expande a 78.3 millones de adultos. RESULTADOS La prevalencia de prediabetes fue de 22.1%, y de diabetes diagnosticada y no diagnosticada de 12.6 y 5.8%, respectivamente, lo que resulta en una prevalencia de diabetes total de 18.3%. Conclusión. La diabetes en México es muy prevalente e implica un reto importante para el sistema de salud. Se requieren acciones contundentes para prevenir la enfermedad, mejorar el tamizaje, el diagnóstico oportuno y el control de la enfermedad.
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Affiliation(s)
- Ana Basto-Abreu
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Nancy López-Olmedo
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Rosalba Rojas-Martínez
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Carlos A Aguilar-Salinas
- Dirección de Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México, México. Nacional de Programas Preventivos y Control de Enfermedades. Ciudad de México, México..
| | - Grea L Moreno-Banda
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Martha Carnalla
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Juan A Rivera
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México. Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Martin Romero-Martinez
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México..
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22
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Vargas-Meza J, Nilson EAF, Nieto C, Khandpur N, Denova-Gutiérrez E, Valero-Morales I, Barquera S, Campos-Nonato I. Modelling the impact of sodium intake on cardiovascular disease mortality in Mexico. BMC Public Health 2023; 23:983. [PMID: 37237296 DOI: 10.1186/s12889-023-15827-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Cardiovascular diseases (CVD) represent the main cause of death in Mexico, while high blood pressure is suffered by about half of the adult population. Sodium intake is one of the main risk factors for these diseases. The Mexican adult population consumes about 3.1 g/day, an amount that exceeds what is recommended by the World Health Organization (WHO) < 2 g sodium/day. The objective of this study was to estimate the impact of reducing sodium intake on CVD mortality in Mexico using a scenario simulation model. METHODS The Integrated Model of Preventable Risk (PRIME) was used to estimate the number of deaths prevented or postponed (DPP) due to CVD in the Mexican adult population following the following sodium intake reduction scenarios: (a) according to the WHO recommendations; (b) an "optimistic" reduction of 30%; and (c) an "intermediate" reduction of 10%. RESULTS The results show that a total of 27,700 CVD deaths could be prevented or postponed for scenario A, 13,900 deaths for scenario B, and 5,800 for scenario C. For all scenarios, the highest percentages of DPP by type of CVD are related to ischemic heart disease, hypertensive disease, and stroke. CONCLUSIONS The results show that if Mexico considers implementing policies with greater impact to reduce sodium/salt consumption, a significant number of deaths from CVD could be prevented or postponed.
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Affiliation(s)
- Jorge Vargas-Meza
- Research Center of Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
- El Poder del Consumidor A.C., Ciudad de México, Mexico
| | - Eduardo Augusto Fernandes Nilson
- Center for Epidemiological Research on Nutrition and Health, School of Public Health, University of Sao Paulo, Sao Paulo, São Paulo, Brazil.
- Programa de Alimentação, Nutrição e Cultura, Oswaldo Cruz Foundation (Fiocruz), Brasília, Brazil.
| | - Claudia Nieto
- Research Center of Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Neha Khandpur
- Department of Nutrition, University of São Paulo, São Paulo, Brazil
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Edgar Denova-Gutiérrez
- Research Center of Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Isabel Valero-Morales
- Research Center of Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Simón Barquera
- Research Center of Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Ismael Campos-Nonato
- Research Center of Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
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23
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Valero-Morales I, Nieto C, García A, Espinosa-Montero J, Aburto TC, Tatlow-Golden M, Boyland E, Barquera S. The nature and extent of food marketing on Facebook, Instagram, and YouTube posts in Mexico. Pediatr Obes 2023; 18:e13016. [PMID: 36867060 DOI: 10.1111/ijpo.13016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 03/04/2023]
Abstract
Food and beverage marketing appealing to children and adolescents has an impact on their food preferences, purchases requests, consumption patterns, health outcomes, and obesity. The objective of this study was to assess the nature and extent of food and beverage marketing on Facebook, Instagram, and YouTube posts in Mexico. This was a content analysis that followed the World Health Organization CLICK methodology to comprehend the landscape of digital food marketing campaigns of the top-selling food products and brands and the most popular accounts carried out between September and October 2020. A total of 926 posts from 12 food and beverage products and 8 brands were included. Facebook was the social media platform with the most posts and greatest engagement. The most prevalent marketing techniques were brand logo, image of packaging, image of the product itself, hashtags, and engagement to consume. Fifty percent of the posts were assessed as appealing to children, 66% to adolescents, and 80% to either children or adolescents. Ninety-one percent of products (n = 1250) were classified as unhealthy according to the Mexican warning labels nutrient profile; 93% of the food promoted on posts appealing to either children or adolescents were unhealthy. Hashtags commonly referred to the COVID-19 pandemic. Most of the unhealthy food digital marketing features marketing techniques that appeal to children or adolescents; moreover, the use of the pandemic hashtag reflected brands' responsiveness to the environment at the time of the study. The present data contribute to evidence supporting the strengthening of food marketing regulations in Mexico.
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Affiliation(s)
- Isabel Valero-Morales
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.,Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Claudia Nieto
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Abad García
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Juan Espinosa-Montero
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Tania C Aburto
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Mimi Tatlow-Golden
- School of Education, Childhood, Youth and Sport, The Open University, Milton Keynes, UK
| | - Emma Boyland
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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24
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Denova-Gutiérrez E, González-Rocha A, Méndez-Sánchez L, Araiza-Nava B, Balderas N, López G, Tolentino-Mayo L, Jauregui A, Hernández L, Unikel C, Bonvecchio A, Shamah T, Barquera S, Rivera JA. Overview of Systematic Reviews of Health Interventions for the Prevention and Treatment of Overweight and Obesity in Children. Nutrients 2023; 15:nu15030773. [PMID: 36771481 PMCID: PMC9921486 DOI: 10.3390/nu15030773] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 01/25/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
(1) Background: The importance of studying the health interventions used to prevent and treat overweight and obesity in school-aged children is imperative. This overview aimed to summarize systematic reviews that assess the effects of school-based, family, and mixed health interventions for preventing and treating overweight and obesity in school-aged children. (2) Methods: The Cochrane Collaboration methodology and PRISMA statement were followed. A search was conducted using terms adapted to 12 databases. Systematic reviews reporting interventions in children from six to 12 years old with an outcome related to preventing or treating obesity and overweight were included. Studies with pharmacological or surgical interventions and adolescents were excluded. (3) Results: A total of 15,226 registers were identified from databases and citation searching. Of those, ten systematic reviews published between 2013 and 2022 were included. After the overlap, 331 interventions for children between 6 and 12 years old were identified, and 61.6% involved physical activity and nutrition/diet intervention. Multicomponent intervention, combining physical activity with nutrition and behavioral change, school-based plus community-based interventions may be more effective in reducing overweight and obesity in children. (4) Conclusions: Plenty of interventions for childhood overweight and obesity aimed at prevention and treatment were identified, but there is a gap in the methodological quality preventing the establishment of a certain recommendation.
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Affiliation(s)
- Edgar Denova-Gutiérrez
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca 62100, Mexico
- Correspondence: ; Tel.: +52-5554322986
| | - Alejandra González-Rocha
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca 62100, Mexico
| | - Lucía Méndez-Sánchez
- Clinical Epidemiology Research Unit & Cochrane Mexico UNAM Center, Hospital Infantil de Mexico Federico Gomez, Mexico City 06720, Mexico
| | - Berenice Araiza-Nava
- Clinical Epidemiology Research Unit & Cochrane Mexico UNAM Center, Hospital Infantil de Mexico Federico Gomez, Mexico City 06720, Mexico
| | - Nydia Balderas
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca 62100, Mexico
| | - Giovanna López
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca 62100, Mexico
| | - Lizbeth Tolentino-Mayo
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca 62100, Mexico
| | - Alejandra Jauregui
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca 62100, Mexico
| | - Lucia Hernández
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca 62100, Mexico
| | - Claudia Unikel
- Departamento de Ciencias Sociales en Salud, Dirección de Investigaciones Epidemiológica y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
| | - Anabelle Bonvecchio
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca 62100, Mexico
| | - Teresa Shamah
- Center for Research in Evaluation and Surveys, National Institute of Public Health, Cuernavaca 62100, Mexico
| | - Simón Barquera
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca 62100, Mexico
| | - Juan A. Rivera
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca 62100, Mexico
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25
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Contreras D, González-Rocha A, Clark P, Barquera S, Denova-Gutiérrez E. Diagnostic accuracy of blood biomarkers and non-invasive scores for the diagnosis of NAFLD and NASH: Systematic review and meta-analysis. Ann Hepatol 2023; 28:100873. [PMID: 36371077 DOI: 10.1016/j.aohep.2022.100873] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION AND OBJECTIVES Fatty liver disease is an important public health problem. Early diagnosis is critical to lower its rate of progression to irreversible/terminal stages. This study aimed to evaluate the accuracy of non-invasive prediction scores for fatty liver disease (NAFLD and NASH) diagnosis in adults. MATERIALS AND METHODS A search was conducted in 10 databases, a qualitative synthesis of 45 studies, and quantitative analysis of the six most common scores. There were 23 risk scores found for NAFLD diagnosis and 32 for NASH diagnosis. The most used were Fatty Liver Index (FLI), aspartate aminotransferase (AST) to Platelet Ratio Index, Fibrosis-4 Index (FIB-4), AST/alanine aminotransferase (ALT) ratio, BARD score, and NAFLD fibrosis score (NFS). RESULTS The results from the meta-analysis for FLI: Area under the curve (AUC) of 0.76 (95% Confidence Interval [CI] 0.73, 0.80), sensitivity 0.67 (CI 95% 0.62, 0.72) and specificity 0.78 (CI 95% 0.74, 0.83). The AST to Platelet Ratio Index: AUC 0.83 (CI 95% 0.80, 0.86), sensitivity 0.45 (95% CI 0.29, 0.62), and specificity of 0.89 (95% CI 0.83, 0.92). The NFS: AUC of 0.82 (CI 95% 0.78, 0.85), sensitivity 0.30 (CI 95% 0.27, 0.33) and specificity 0.96 (CI 95% 0.95,0.96). CONCLUSIONS The FLI for NAFLD and AST to Platelet Ratio Index for NASH were the risk scores with the highest prognostic value in the included studies. Further research is needed for the application of new diagnostic risk scores for NAFLD and NASH.
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Affiliation(s)
- Daniela Contreras
- Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | | | - Patricia Clark
- Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico; Clinical Epidemiology Research Unit, Children Hospital of Mexico "Federico Gómez", Mexico City, Mexico
| | - Simón Barquera
- Nutrition, and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - Edgar Denova-Gutiérrez
- Nutrition, and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico.
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26
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Jáuregui A, Pacheco-Miranda S, Ayvar-Gama Y, Alejandro-Torres NZ, Cuno A, Espinosa-de Candido AF, Martínez-Cruz MI, Bonvecchio-Arenas A, Barquera S. Diseño de una estrategia de comunicación para la promoción del uso del etiquetado de advertencia en niños, niñas y adolescentes mexicanos. Salud Publica Mex 2023; 65:70-81. [PMID: 36750070 DOI: 10.21149/14120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/08/2022] [Indexed: 01/20/2023] Open
Abstract
OBJETIVO Describir el proceso para diseñar una estrategia de comunicación con el fin de promover el uso del etiqueta-do frontal de advertencia (EFA) y la selección de alimentos saludables en niños, niñas y adolescentes (NNA) mexicanos. Material y métodos. Estudio de cuatro fases con esco-lares, adolescentes y cuidadores: 1) investigación formativa (18 grupos focales, n= 179); 2) talleres de cocreación con NNA (n= 33); 3) diseño de la estrategia, con base en el modelo de comportamiento COM-B; y 4) prueba piloto (seis grupos focales, n= 52). RESULTADOS La estrategia de comunicación debería mejorar la comprensión del EFA y los conocimientos sobre la relación de los ingredientes críticos (calorías, grasas saturadas, grasas trans, sodio, edulcorantes y cafeína) y la enfermedad; asimismo, debería resaltar las consecuencias positivas de una alimentación saludable y las negativas del consumo excesivo de alimentos con sellos, así como destacar que los alimentos naturales tienen un menor costo y mejor calidad que los alimentos con sellos; se deben ofrecer sugerencias de preparaciones atractivas y saludables con alimentos naturales. Conclusión. La investigación formativa y la participación de NNA en la creación de la campaña fueron esenciales para diseñar una estrategia cultu-ralmente pertinente con potencial de impacto. El proceso y los resultados del estudio podrían informar sobre esfuerzos en contextos parecidos al de México.
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Affiliation(s)
- Alejandra Jáuregui
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México.
| | - Selene Pacheco-Miranda
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México.
| | - Yatziri Ayvar-Gama
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México.
| | | | - Amalia Cuno
- Centro de Investigación y de Estudios Avanzados, Instituto Politécnico Nacional. Ciudad de México, México.
| | | | | | - Anabelle Bonvecchio-Arenas
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México.
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México.
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Argumedo G, Cruz-Casarrubias CA, Bonvecchio-Arenas A, Jáuregui A, Saavedra-Romero A, Martínez-Montañez OG, Meléndez-Irigoyen MT, Karam-Araujo R, Uribe-Carvajal R, Olvera A, Hernández-Alcaráz C, Velázquez Cortés D, Morales-Ruán MDC, Shamah-Levy T, Nieto C, Contreras-Manzano A, Hernández-Ávila M, Rivera-Dommarco J, Barquera S. Hacia el diseño de Vida Saludable, un nuevo programa de estudios para la educación básica en México. Salud Publica Mex 2023; 65:82-92. [PMID: 36750063 DOI: 10.21149/14212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 11/24/2022] [Indexed: 01/20/2023] Open
Abstract
OBJETIVO Describir el proceso de diseño de Vida Saludable, un nuevo programa de estudios para la educación básica en México. Material y métodos. Se conformó un equipo de trabajo entre especialistas en salud y la Secretaría de Educación Pública. Se establecieron las bases científicas de Vida Saludable, se seleccionaron y evaluaron materiales para Vida Saludable, y se revisaron contenidos vigentes de salud incluidos en otras asignaturas. RESULTADOS Alimentación, actividad física e higiene y limpieza fueron definidos como los tres ejes temáticos para Vida Saludable. Se aprobaron 3 de 228 insumos para usarse en Vida Saludable y 71.7% de los con-tenidos vigentes en educación básica sobre salud requieren ediciones. CONCLUSIONES Vida Saludable es un parteaguas hacia la alfabetización en materia de salud en educación básica en México, que se alinea con la agenda global para preservar la salud humana y planetaria.
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Affiliation(s)
- Gabriela Argumedo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, México.
| | | | | | - Alejandra Jáuregui
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, México.
| | | | | | | | | | - Rebeca Uribe-Carvajal
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. Cuernavaca, México.
| | - Armando Olvera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, México.
| | - César Hernández-Alcaráz
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, México.
| | - Daniel Velázquez Cortés
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, México.
| | | | - Teresa Shamah-Levy
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. Cuernavaca, México..
| | - Claudia Nieto
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, México.
| | | | | | - Juan Rivera-Dommarco
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, México..
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, México.
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Unar-Munguía M, Santos-Guzmán A, Mota-Castillo PJ, Ceballos-Rasgado M, Tolentino-Mayo L, Sachse Aguilera M, Cobo Armijo F, Barquera S, Bonvecchio A. Digital marketing of formula and baby food negatively influences breast feeding and complementary feeding: a cross-sectional study and video recording of parental exposure in Mexico. BMJ Glob Health 2022; 7:bmjgh-2022-009904. [PMCID: PMC9594510 DOI: 10.1136/bmjgh-2022-009904] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/24/2022] [Indexed: 11/03/2022] Open
Abstract
Background Objective Methods Results Conclusions
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Affiliation(s)
- Mishel Unar-Munguía
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Andrea Santos-Guzmán
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | | | - Lizbeth Tolentino-Mayo
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | | | - Simón Barquera
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Anabelle Bonvecchio
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
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Colli VA, González-Rocha A, Canales D, Hernández-Alcáraz C, Pedroza A, Pérez-Chan M, Barquera S, Denova-Gutierrez E. Chronic kidney disease risk prediction scores assessment and development in Mexican adult population. Front Med (Lausanne) 2022; 9:903090. [PMID: 36341240 PMCID: PMC9631933 DOI: 10.3389/fmed.2022.903090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 10/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background Chronic kidney disease (CKD) is a major public health problem, with considerable growth in prevalence and mortality in recent years. Screening of CKD at primary care is crucial for the implementation of prevention strategies. The aims of this study are to assess CKD risk prediction scores and to develop a risk prediction score for the Mexican adult population. Methods Data from the Mexican National Health and Nutrition Survey 2016 was utilized and 3463 participants ≥ 20 years old were included. Reduced renal function with Glomerular filtration rate and/or the presence of albuminuria was defined as CKD. Multiple logistic regression models were performed for the creation of a training and validation model. Additionally, several models were validated in our Mexican population. Results The developed training model included sex, age, body mass index, fast plasma glucose, systolic blood pressure, and triglycerides, as did the validation model. The area under the curve (AUC) was 0.78 (95% CI: 0.72, 0.79) for training model, and 0.76 (95% CI: 0.71, 0.80) in validation model for Mexican adult population. Age, female gender, presence of diabetes and hypertension, elevated systolic and diastolic blood pressure, serum and urinary creatinine, and higher HbA1c were significantly associated with the prevalent chronic kidney disease. Previous CKD risk predictive models were evaluated with a representative sample of the Mexican adult population, their AUC was between 0.61 and 0.78. Conclusion The designed CKD risk predictive model satisfactorily predicts using simple and common variables in primary medical care. This model could have multiple benefits; such as, the identification of the population at risk, and prevention of CKD.
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Affiliation(s)
- Victor A. Colli
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, Mexico
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Alejandra González-Rocha
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - David Canales
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Cesar Hernández-Alcáraz
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Andrea Pedroza
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Manuel Pérez-Chan
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, Mexico
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Edgar Denova-Gutierrez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
- *Correspondence: Edgar Denova-Gutierrez,
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Durán R, Asmitia E, Rivera J, Barquera S, Tolentino-Mayo L. Analysis of stakeholders' responses to the food warning labels regulation in Mexico. Health Res Policy Syst 2022; 20:108. [PMID: 36242086 PMCID: PMC9568963 DOI: 10.1186/s12961-022-00922-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 09/22/2022] [Indexed: 11/23/2022] Open
Abstract
Background In Mexico, the inclusion of a front-of-pack label in the Official Mexican Standard 051 (NOM-051 for its Spanish acronym) has been widely discussed for years by different stakeholder groups. In 2019, the NOM-051 modification project was proposed, which included front-of-pack warning labels. To be modified, it underwent a public consultation period where stakeholders sent their comments to be reviewed and considered. The purpose of this study was to analyse the stakeholders’ perspectives during the public consultation of the NOM-051 modification project. Methods To assess perspectives, the 795 comments available on the National Commission for Regulatory Improvement website were analysed. Identity, expectations and demands were identified from each comment using content analysis in NVivo. In addition, frequencies and percentages were obtained. Results Fifty-six percent of the comments were opposed to the NOM-051 modification project. Industry and business interest nongovernmental organizations were against it; they considered that their revenues and profits would be affected. Public interest nongovernmental organizations, academia and health professionals were in favour, stating that the changes proposed are fundamental to informing consumers and improving food choices, and an essential factor in reducing the prevalence of overweight and obesity. Stakeholders in favour expected that eating habits would improve, and demanded that the front-of-pack warning label suggested in the modification proposal be maintained. Conclusions The comments opposed to the NOM-051 modification project were consistent with the literature, indicating that food industry stakeholders use all possible arguments to interfere in public health policies. The main issues used by the food industry to discredit the NOM-051 modification project coincide with those used in other countries to stop public health policies and with those used by the tobacco industry to avoid market regulations. On the other hand, those in favour looked after the interests of the Mexican population.
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Affiliation(s)
- Regina Durán
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Edalith Asmitia
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Juan Rivera
- Population Health Research Center, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Lizbeth Tolentino-Mayo
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico.
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Barquera S. Intersection of public health, nutrition, and mental health: Challenges to progress. Salud Ment 2022. [DOI: 10.17711/sm.0185-3325.2022.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Antonio-Villa NE, Bello-Chavolla OY, Fermín-Martínez CA, Aburto JM, Fernández-Chirino L, Ramírez-García D, Pisanty-Alatorre J, González-Díaz A, Vargas-Vázquez A, Barquera S, Gutiérrez-Robledo LM, Seiglie JA. Socio-demographic inequalities and excess non-COVID-19 mortality during the COVID-19 pandemic: a data-driven analysis of 1 069 174 death certificates in Mexico. Int J Epidemiol 2022; 51:1711-1721. [PMID: 36174226 PMCID: PMC9619535 DOI: 10.1093/ije/dyac184] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/08/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND In 2020, Mexico experienced one of the highest rates of excess mortality globally. However, the extent of non-COVID deaths on excess mortality, its regional distribution and the association between socio-demographic inequalities have not been characterized. METHODS We conducted a retrospective municipal and individual-level study using 1 069 174 death certificates to analyse COVID-19 and non-COVID-19 deaths classified by ICD-10 codes. Excess mortality was estimated as the increase in cause-specific mortality in 2020 compared with the average of 2015-2019, disaggregated by primary cause of death, death setting (in-hospital and out-of-hospital) and geographical location. Correlates of individual and municipal non-COVID-19 mortality were assessed using mixed effects logistic regression and negative binomial regression models, respectively. RESULTS We identified a 51% higher mortality rate (276.11 deaths per 100 000 inhabitants) compared with the 2015-2019 average period, largely attributable to COVID-19. Non-COVID-19 causes comprised one-fifth of excess deaths, with acute myocardial infarction and type 2 diabetes as the two leading non-COVID-19 causes of excess mortality. COVID-19 deaths occurred primarily in-hospital, whereas excess non-COVID-19 deaths occurred in out-of-hospital settings. Municipal-level predictors of non-COVID-19 excess mortality included levels of social security coverage, higher rates of COVID-19 hospitalization and social marginalization. At the individual level, lower educational attainment, blue-collar employment and lack of medical care assistance prior to death were associated with non-COVID-19 deaths. CONCLUSION Non-COVID-19 causes of death, largely chronic cardiometabolic conditions, comprised up to one-fifth of excess deaths in Mexico during 2020. Non-COVID-19 excess deaths occurred disproportionately out-of-hospital and were associated with both individual- and municipal-level socio-demographic inequalities.
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Affiliation(s)
- Neftali Eduardo Antonio-Villa
- Corresponding author. Division de Investigación, Instituto Nacional de Geriatría, Anillo Perif. 2767, San Jerónimo Lídice, La Magdalena Contreras, 10200 Mexico City, Mexico. E-mail:
| | | | - Carlos A Fermín-Martínez
- Division de Investigación, Instituto Nacional de Geriatría, Mexico City, Mexico,MD/PhD (PECEM) Program, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - José Manuel Aburto
- Leverhulme Centre for Demographic Science, Department of Sociology, University of Oxford, Oxford, United Kindom,Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, Odense, Denmark
| | - Luisa Fernández-Chirino
- Division de Investigación, Instituto Nacional de Geriatría, Mexico City, Mexico,Faculty of Chemistry, National Autonomous University of Mexico, Mexico City, Mexico
| | | | - Julio Pisanty-Alatorre
- Instituto Mexicano del Seguro Social, Mexico City, Mexico,Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Armando González-Díaz
- Facultad de Ciencias Politicas Sociales y Sociales, National Autonomous University of Mexico, Mexico City, Mexico
| | - Arsenio Vargas-Vázquez
- Division de Investigación, Instituto Nacional de Geriatría, Mexico City, Mexico,MD/PhD (PECEM) Program, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Simón Barquera
- Health and Nutrition Research Center, National Institute of Public Health, Cuernavaca, Mexico
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Barquera S. Importancia de las políticas públicas para atender problemas de nutrición de niños, niñas y adolescentes. Rev Esp Nutr Hum Diet 2022. [DOI: 10.14306/renhyd.26.s2.1763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Campos-Nonato I, Cervantes-Armenta MA, Pacheco-Miranda S, Quezada-Sánchez AD, Contreras-Manzano A, Barquera S, Vargas-Meza J. Perception and Understanding of Guideline Daily Amount and Warning Labeling among Mexican Adults during the Law Modification Period. Nutrients 2022; 14:nu14163403. [PMID: 36014909 PMCID: PMC9415154 DOI: 10.3390/nu14163403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 12/05/2022] Open
Abstract
Front-of-pack labeling (FOPL) is a tool that enables consumers to compare foods and select healthier options. Due to low understanding of the Guideline Daily Amount (GDA) labeling among Mexicans, a law was implemented in October 2020 that modified the FOPL to a warning labeling (WL) system. The purpose of this study was to compare the perception and understanding of GDA and WL during the law modification period. We conducted a panel design with two measurements: (1) using GDA label (September 2020) and (2) using WL (October–November). We estimated differences in GDA vs. WL through multinomial logistic regression models and changes were measured through predictive margin contrasts and Wald tests. When comparing the same products with different labels, the participants reported that it would be unlikely/very unlikely that they would consume products packaged with the WL (81.5%; 95%CI: 79.2, 83.8) compared to those with GDA (24.2%; 95%CI: 21.7, 26.7). Consumers’ perception was that the quantities of packaged products they should consume was small or very small when they used the WL (93.8%; 95%CI: 92.4, 95.5) compared to GDA (41.6%; 95%CI: 39.7, 44.6). When comparing food groups, participants were more confident about choosing healthy products when using the WL compared to the GDA. During the implementation of WL in Mexico, the studied population had a better perception and understanding of less healthy packaged foods when using WL, compared to the GDA label.
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Affiliation(s)
- Ismael Campos-Nonato
- Center for Nutrition and Health Research, National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca C.P. 62100, Morelos, Mexico
| | - Manuel A. Cervantes-Armenta
- Center for Nutrition and Health Research, National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca C.P. 62100, Morelos, Mexico
| | - Selene Pacheco-Miranda
- Center for Nutrition and Health Research, National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca C.P. 62100, Morelos, Mexico
| | - Amado D. Quezada-Sánchez
- Center for Research in Evaluation and Surveys, National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca C.P. 62100, Morelos, Mexico
| | - Alejandra Contreras-Manzano
- Center for Nutrition and Health Research, National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca C.P. 62100, Morelos, Mexico
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca C.P. 62100, Morelos, Mexico
| | - Jorge Vargas-Meza
- Center for Nutrition and Health Research, National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca C.P. 62100, Morelos, Mexico
- Correspondence:
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Denova-Gutiérrez E, Méndez-Sánchez L, Araiza-Nava B, González-Rocha A, Shamah T, Bonvechio A, Barquera S, Rivera J. Overview of systematic reviews of health interventions that aim to prevent and treat overweight and obesity among children. Syst Rev 2022; 11:168. [PMID: 35964113 PMCID: PMC9375347 DOI: 10.1186/s13643-022-02047-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 08/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Childhood overweight and obesity is a global public health issue. Although there is evidence of a reduced prevalence in some countries, there is still much controversy about the efficacy of health interventions that aim to prevent and treat obesity in this specific population. The objective of the present study is to develop an overview of systematic reviews (OSRs) that assesses the effects of school-based, family, and multi-component health interventions for the prevention and treatment of obesity, change in physical activity, dietary, and/or hydration behaviors, and change in metabolic risk factors in school-aged children. METHODS This protocol was developed using the methodology proposed by Cochrane. It outlines a comprehensive search in 12 electronic databases to identify systematic reviews of health interventions, including studies that evaluate and how to prevent and/or treat overweight and/or obesity in children aged 6 to 12 years. The risk of bias of the included Systematic Reviews will be assessed with the ROBIS tool. DISCUSSION Since the OSRs methodology's purpose is only to harmonize evidence from open access publications, ethical consent is not necessary for the present protocol. In terms of diffusion, a paper will be submitted for publication in a scientific journal to describe the main results obtained through the OSRs. TRIAL REGISTRATION The present overview of the systematic review protocol has been registered in PROSPERO (ID number 218296).
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Affiliation(s)
- Edgar Denova-Gutiérrez
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - Lucía Méndez-Sánchez
- Clinical Epidemiology Research Unit, Hospital Infantil de Mexico Federico Gomez, Faculty of Medicine of National Autonomous University of Mexico (Universidad Nacional Autónoma de México), Mexico City, Mexico.
| | - Berenice Araiza-Nava
- Clinical Epidemiology Research Unit, Hospital Infantil de Mexico Federico Gomez, Faculty of Medicine of National Autonomous University of Mexico (Universidad Nacional Autónoma de México), Mexico City, Mexico
| | | | - Teresa Shamah
- Center for Research in Evaluation and Surveys, National Institute of Public Health, Cuernavaca, Mexico
| | - Anabelle Bonvechio
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - Simón Barquera
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - Juan Rivera
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Mexico.
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Oviedo-Solís CI, Hernández-Alcaraz C, Sánchez-Ortíz NA, López-Olmedo N, Jáuregui A, Barquera S. Association of sociodemographic and lifestyle factors with dietary patterns among men and women living in Mexico City: A cross-sectional study. Front Public Health 2022; 10:859132. [PMID: 36062124 PMCID: PMC9429794 DOI: 10.3389/fpubh.2022.859132] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 07/19/2022] [Indexed: 01/21/2023] Open
Abstract
Background Diet is one of the leading risk factors for non-communicable diseases and is related to sociodemographic and lifestyle factors, including sex. These associations vary across populations. We aimed to investigate which factors are associated with dietary patterns among adults living in Mexico City by sex. Methods We used data from the Mexico City Diabetes Representative Study, a cross-sectional, multistage, stratified, and cluster-sampled survey in Mexico City (n = 1,142; 413 men and 729 women). Dietary information was collected using a semi-quantitative food frequency questionnaire. Foods and beverages were categorized into 23 food groups to identify dietary patterns by cluster analysis. Sociodemographic and lifestyle variables included were self-reported through standardized questionnaires. We assessed the association of sociodemographic and lifestyle factors with dietary patterns through a multinomial logistic model stratified by sex. Results We identified three dietary patterns: basic, prudent, and fast food. Among men and women, higher school attainment was associated with a lower relative probability of having a basic rather than prudent dietary pattern (women: RRR = 0.8, 95% CI: 0.8, 0.9; men: RRR = 0.8, 95% CI: 0.7, 0.9). Divorced or separated men (RRR = 3.8, 95% CI: 1.3, 11.2) and those living with a partner (RRR = 2.6, 95% CI: 1.1, 6.1) had a higher relative probability of consuming a fast food dietary pattern than the prudent one, compared to single men. Men living with a partner (RRR = 3.0, 95% CI: 1.1, 8.6) or working long shifts (RRR = 3.8, 95% CI: 1.3, 11.1) had a higher probability of consuming a basic pattern rather than a prudent one compared to peers. Among women, those with high SES had a lower probability of consuming the "basic" pattern rather than the "prudent" pattern compared to those with low SES. No lifestyle factors were associated to dietary patterns. Conclusions Men living in Mexico City with lower education, age, non-single, and working long hours (i.e., more than the established by the law), and women with lower age, education, and socioeconomic level are prone to adhere to unhealthy diets. These associations are likely to be driven by gender roles.
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Affiliation(s)
| | - César Hernández-Alcaraz
- Center of Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Nancy López-Olmedo
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Alejandra Jáuregui
- Center of Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico,*Correspondence: Alejandra Jáuregui
| | - Simón Barquera
- Center of Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
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Rodríguez-Guerra AI, López-Olmedo N, Medina C, Hernández-Alcaraz C, Ortega-Avila AG, Barquera S. Association between density of convenience and small grocery stores with diet quality in adults living in Mexico City: A cross sectional study. Front Public Health 2022; 10:857754. [PMID: 35991079 PMCID: PMC9389155 DOI: 10.3389/fpubh.2022.857754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 07/19/2022] [Indexed: 12/03/2022] Open
Abstract
There is evidence of the association between different retail stores and food consumption, yet research is still limited in low- and medium-income countries, where the context of the food retail environment is different from that observed in high-income countries. Specifically, less is known about how convenience and small grocery stores, which offer products with immediate access, are associated with the diet as a whole. The present study assessed the association between density of convenience and small grocery stores and diet quality in adults from the Mexico City Representative Diabetes Survey 2015. A final sample size of 1,023 adults aged 20–69 years was analyzed. The density of stores was measured using Euclidean buffers within 500 meters of each participant's home. The Mexican Alternate Healthy Eating Index (MxAHEI) was used to assess diet quality. Multivariable Poisson models were used to test the association of convenience and small grocery stores densities with the MxAHEI. Although our results were not statistically significant, we observed a lower diet quality score among adults from Mexico City living in areas with a higher density of small grocery and convenience stores. More research is needed on the influence of environmental food retail on food consumption.
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Affiliation(s)
| | - Nancy López-Olmedo
- Center for Population and Health Research, National Institute of Public Health, Cuernavaca, Mexico
- *Correspondence: Nancy López-Olmedo
| | - Catalina Medina
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | - César Hernández-Alcaraz
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Ana G. Ortega-Avila
- Institute of Geography, National Autonomous University of Mexico, Ciudad de Mexico, Mexico
| | - Simón Barquera
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
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Contreras-Manzano A, Jáuregui A, Vargas-Meza J, Nieto C, Granich-Armenta A, de Lourdes Alemán Escobar M, G-Olvera A, Cruz-Casarrubias C, Munguía A, Barquera S. Objective understanding of front of pack warning labels among Mexican children of public elementary schools. A randomized experiment. Nutr J 2022; 21:47. [PMID: 35864545 PMCID: PMC9306177 DOI: 10.1186/s12937-022-00791-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 05/31/2022] [Indexed: 01/28/2023] Open
Abstract
Background Warning Labels (WL) highlight excessive amounts of critical nutrients in order to discourage consumption of unhealthful packaged food products. This study aimed to evaluate among Mexican school children, the objective understanding of traditional and numeric WL (aimed at small products) considered by the Mexican regulation, and whether cartoon characters influenced the understanding of WL. We also tested some communication strategies to facilitate the correct use of the WL. Methods We carried out a randomized experiment in July 2019 in public elementary schools from Morelos, Mexico. Participants aged 6–13 years, were randomly assigned to one of four groups: 1) Nutrient Facts Panel (NF) (n = 120), 2) Nutrient Facts Panel with cartoon characters (NF + C) (n = 83), considered the control groups, 3) Warning Labels (WL) (n = 109), and 4) Warning Labels with cartoon characters (WL + C) (n = 96). After allocation, children assigned to both WL groups (WL or WL + C), were randomly required to watch two posters simultaneously or a video explaining how to correctly interpret WLs. Logistic regression models adjusted by sex, age and cluster (school) were fitted. Results The percentage of children correctly choosing the healthiest or the unhealthiest option was higher for WL groups (56.8, 95%CI; 40.8–72.8) compared to NF groups (24.3, 95%CI; 20.4–28.3, p < 0.05). The understanding of traditional WL was higher (28.7, 95%CI: 22.8–35.4) than the numeric WL (19, 95%CI: 14.2–25.0, p < 0.05). But, correct answers for identifying healthy and unhealthy products were higher for numeric WL than for NF groups. Cartoon characters reduced the percentage of correct answers for choosing unhealthiest products (WL + C: 48.9, 95%CI: 25.6–72.4 vs WL: 58.7, 95%CI: 36.4–81.1, p < 0.05). The video was 2.23 times more helpful than the posters to the correct interpretation of the WL (p < 0.05). Conclusions In scholar Mexican children, traditional and numeric WL were useful to identify healthier and unhealthier packaged products in comparison to NF, suggesting that both WL formats may effectively communicate the excessive content of nutrients of concern among children. Cartoon characters may reduce the objective understanding of the WL, underscoring the need to regulate advertising directed to children along with the implementation of front-of-pack labeling. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-022-00791-z.
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Affiliation(s)
| | - Alejandra Jáuregui
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico.
| | - Jorge Vargas-Meza
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico
| | - Claudia Nieto
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico
| | - Adriana Granich-Armenta
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico
| | | | - Armando G-Olvera
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico
| | - Carlos Cruz-Casarrubias
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico
| | - Ana Munguía
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico
| | - Simón Barquera
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100, Cuernavaca, Mexico
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Medina C, Piña-Pozas M, Aburto TC, Chavira J, López U, Moreno M, Olvera AG, Gonzalez C, Huang TTK, Barquera S. Systematic literature review of instruments that measure the healthfulness of food and beverages sold in informal food outlets. Int J Behav Nutr Phys Act 2022; 19:89. [PMID: 35842649 PMCID: PMC9288710 DOI: 10.1186/s12966-022-01320-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 06/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Informal food outlets, defined as vendors who rarely have access to water and toilets, much less shelter and electricity, are a common component of the food environment, particularly in many non-Western countries. The purpose of this study was to review available instruments that measure the quality and particularly the healthfulness of food and beverages sold within informal food outlets. METHODS PubMed, LILACS, Web of Science, and Scopus databases were used. Articles were included if they reported instruments that measured the availability or type of healthy and unhealthy foods and beverages by informal food outlets, were written in English or Spanish, and published between January 1, 2010, and July 31, 2020. Two trained researchers reviewed the title, abstract and full text of selected articles; discrepancies were solved by two independent researchers. In addition, the list of references for selected articles was reviewed for any additional articles of relevance. The quality of published articles and documents was evaluated using JBI Critical appraisal checklist for analytical cross-sectional studies. RESULTS We identified 1078 articles of which 14 were included after applying the selection criteria. Three additional articles were considered after reviewing the references from the selected articles. From the final 17 articles, 13 measurement tools were identified. Most of the instruments were used in low- and middle-income countries (LMIC). Products were classified as healthy/unhealthy or produce/non-produce or processed/unprocessed based on availability and type. Six studies reported psychometric tests, whereas one was tested within the informal food sector. CONCLUSIONS Few instruments can measure the healthfulness of food and beverages sold in informal food outlets, of which the most valid and reliable have been used to measure formal food outlets as well. Therefore, it is necessary to develop an instrument that manages to measure, specifically, the elements available within an informal one. These actions are extremely important to better understand the food environment that is a central contributor to poor diets that are increasingly associated with the obesity and Non-communicable disease (NCD) pandemic.
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Affiliation(s)
- Catalina Medina
- Center for Health and Nutrition Research, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico
| | - Maricela Piña-Pozas
- Center for Information for Public Health Decisions, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico
| | - Tania C Aburto
- Center for Health and Nutrition Research, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico
| | - Julissa Chavira
- Center for Health and Nutrition Research, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico
| | - Uzzi López
- Center for Health and Nutrition Research, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico
| | - Mildred Moreno
- School of Engineering and Architecture (ESIA), National Polytechnic Institute (IPN), México, Avenida Fuentes de los Leones 28, Lomas de Tecamachalco. CP. 53955. Tecamachalco, Naucalpan, Mexico
| | - Armando G Olvera
- Center for Health and Nutrition Research, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico
| | - Citlali Gonzalez
- Center for Health and Nutrition Research, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico
| | - Terry T-K Huang
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health and Health Policy, City University of New York, 55W. 125 Street, Room 803, New York, NY, 10027, USA
| | - Simón Barquera
- Center for Health and Nutrition Research, National Institute of Public Health, Mexico. Avenida Universidad 655, Santa María Ahuacatitlán. CP. 06210, Cuernavaca, Morelos, Mexico.
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Medina C, Hernández A, Hermosillo-Gallardo ME, Gómez Gámez CI, Resendiz E, Morales M, Nieto C, Moreno M, Barquera S. Development and Validation of the Mexican Public Open Spaces Tool (MexPOS). Int J Environ Res Public Health 2022; 19:ijerph19138198. [PMID: 35805857 PMCID: PMC9266626 DOI: 10.3390/ijerph19138198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/24/2022] [Accepted: 06/29/2022] [Indexed: 02/04/2023]
Abstract
Public open spaces (POS) are "publicly owned spaces such as parks, green areas, squares, marketplaces, streets and highways which are of public access". Some attributes could increase or decrease participants' attendance. Thus, reliable and valid audit tools are needed in order to measure these attributes. This study aimed to develop and validate a tool to assess POS features within the Mexico City context. The Mexican Public Open Spaces Tool (MexPOS) was developed based on (1) two validated POS audit tools, (2) several visits to the POS, (3) pilot testing, and (4) multiple work sessions with a group of specialists. The original tool included 181 items divided into nine sections. Trained personnel visited and evaluated 944 POS in Mexico City. An exploratory factor analysis was performed to examine the construct validity of the items and the relationship between the subscales. The final model resulted in seven factors: (1) Food and Wellness Environment (α = 0.15), (2) Maintenance (α = 0.81), (3) Amenities (α = 0.72), (4) Legibility (α = 0.59), (5) Security (α = 0.48), (6) Perceived Environment (α = 0.65), and (7) Urban Environment (α = 0.58). Our study highlights the relevance of using a validated tool to measure POS characteristics related to participants' attendance to help assess infrastructure improvements and identify priority areas for changing socio-urban environments for physical activity.
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Affiliation(s)
- Catalina Medina
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca 62100, Mexico; (A.H.); (M.E.H.-G.); (M.M.); (C.N.); (S.B.)
- Correspondence:
| | - Annel Hernández
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca 62100, Mexico; (A.H.); (M.E.H.-G.); (M.M.); (C.N.); (S.B.)
| | - Maria E. Hermosillo-Gallardo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca 62100, Mexico; (A.H.); (M.E.H.-G.); (M.M.); (C.N.); (S.B.)
| | - Célida I. Gómez Gámez
- Departamento de Arquitectura, Urbanismo e Ingeniería Civil, Universidad Iberoamericana, Mexico City 01219, Mexico;
| | - Eugen Resendiz
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO 63130, USA;
| | - Maricruz Morales
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca 62100, Mexico; (A.H.); (M.E.H.-G.); (M.M.); (C.N.); (S.B.)
| | - Claudia Nieto
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca 62100, Mexico; (A.H.); (M.E.H.-G.); (M.M.); (C.N.); (S.B.)
| | - Mildred Moreno
- Escuela de Ingeniería y Arquitectura (ESIA), Instituto Politécnico Nacional (IPN), Mexico City 07340, Mexico;
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca 62100, Mexico; (A.H.); (M.E.H.-G.); (M.M.); (C.N.); (S.B.)
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Sagaceta-Mejía J, Tolentino-Mayo L, Cruz-Casarrubias C, Nieto C, Barquera S. Understanding of front of package nutrition labels: Guideline daily amount and warning labels in Mexicans with non-communicable diseases. PLoS One 2022; 17:e0269892. [PMID: 35749373 PMCID: PMC9231753 DOI: 10.1371/journal.pone.0269892] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/29/2022] [Indexed: 11/19/2022] Open
Abstract
One strategy for the prevention and treatment of non-communicable diseases (NCDs) is the implementation of the front-of-pack labeling (FoPL) in foods and beverages. In 2020, Mexico adopted the warning label system (WL) as a new public health policy, whose aim is to help consumers make healthier food choices. Previously, the Guideline Daily Amount (GDA) was the labelling used it. This paper aims to compare the understanding of two FoPL, the GDA and the WL, through the identification of unhealthy products in Mexicans with NCDs. We analyzed data from 14,880 Mexican adults older than 20 years old with NCDs (overweight-obesity (OW/O), self-reported diabetes mellitus 2 (DM2), or/and hypertension (HT), or/and dyslipidemia (Dys)). Participants were randomly assigned to one of two groups: the GDA labeling or WL. Each group had to respond to a survey and had to classify food products images as healthy or unhealthy according to the labelling system to which they were assigned. The correct classification was determined according to the criteria of Chile’s labeling nutrient profile stage 3. To evaluate the correct classification in each one of the groups we evaluated the differences in proportions. Logistic regression models were used to assess the likelihood to correctly classify the product according to participants’ number of diseases and WL information, taking GDA label as a reference. Participants who used the information contained in the GDA label misclassified food product labels in greater proportion (70%), mostly participants with three or more NCDs (participants with OW/O+ HT+ Dys, represent 42.3% of this group); compared with those who used WL (50%). The odds of correct classification of food products using WL image were two times greater compared to GDA image in participants with NCDs; being greater in participants with three or more NCDs. The study results highlight the usefulness of WL as it helps Mexicans with NCDs to classify unhealthy food products more adequately compared with GDA.
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Affiliation(s)
- Janine Sagaceta-Mejía
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Lizbeth Tolentino-Mayo
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
- * E-mail:
| | - Carlos Cruz-Casarrubias
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Claudia Nieto
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Simón Barquera
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
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Hock K, Barquera S, Corvalán C, Goodman S, Sacks G, Vanderlee L, White CM, White M, Hammond D. Awareness of and Participation in School Food Programs in Youth from Six Countries. J Nutr 2022; 152:85S-97S. [PMID: 35274730 PMCID: PMC9188863 DOI: 10.1093/jn/nxac052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/25/2022] [Accepted: 03/03/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND School-based meal programs can promote healthy dietary intake in youth. However, limited data exist regarding the impact of income-targeted school meal programs across countries, particularly among food-insecure youth. OBJECTIVES We examined self-reported awareness of and participation in free school meal programs, and associations with dietary intake in youth from 6 countries with differing national school meal policies. METHODS Data were collected through the 2019 International Food Policy Study Youth Survey, a cross-sectional survey of 10,565 youth aged 10-17 y from Australia, Canada, Chile, Mexico, the United Kingdom, and the United States. Regression models examined: 1) country differences in awareness of and participation in breakfast and lunch programs; and 2) associations between lunch program participation and intake of fruit and vegetables, and "less healthy" foods during the previous school lunch day. RESULTS Awareness of and participation in free breakfast and lunch programs varied across countries. Approximately half of USA and Chilean students participated in school lunch programs-the countries with the most comprehensive national policies-compared with one-fifth of students in the United Kingdom, and ∼5% in Australia, Canada, and Mexico (P < 0.001 for all contrasts). In the United States and Chile, more than two-thirds of youth with the highest level of food insecurity participated in lunch programs, compared with 45% in the United Kingdom, 27% in Canada, and ≤20% in Australia and Mexico. In all countries, youth reporting school lunch program participation were more likely to report fruit and vegetable intake during their previous school lunch (P < 0.001), and higher intake of "less healthy" food in all countries except the United States and Chile. CONCLUSIONS More comprehensive national policies were associated with greater participation in school meal programs, particularly among youth at greatest risk of food insecurity, as well as healthier dietary intake from school lunches.
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Affiliation(s)
- Karen Hock
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Camila Corvalán
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Samantha Goodman
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Gary Sacks
- Global Obesity Centre, Deakin University, Melbourne Burwood Campus, Burwood, Victoria, Australia
| | - Lana Vanderlee
- École de Nutrition, Centre Nutrition, santé et société (Centre NUTRISS), and Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada
| | - Christine M White
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Martin White
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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Alcalde-Rabanal JE, Nieto-Orozco C, Carriedo Á, Mena C, Barquera S. Behavioral and normative beliefs that influence Mexican consumers to purchase packaged food in urban supermarkets. Salud Publica Mex 2022; 64:280-289. [DOI: 10.21149/12741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 03/16/2022] [Indexed: 11/06/2022] Open
Abstract
Objective. To identify the behavioral and normative believes factors that might have major influence on the decision to buy packaged foods in urban Mexican families. Materials and methods. We performed a cross-sectional study in four urban cities of Mexico. Participants responded a self-administered questionnaire (n=3 340) outside of randomly selected supermarkets. A factor analysis was performed to identify what were the main behavioral and normative believes explaining consumers’ decision when buying packaged foods. Results. Three factors explained the behavioral beliefs: the quality assessment of packaged foods explained 61% of the variance, products that maintain weight explained 25%, and the emotional experience with foods explained 13%. Three factors explained the normative beliefs: expectations of children and partner explained 46% of the variance, expectations from the participants’ closest friends 23%, and expectation from other family members explained 14%. Conclusion. Behavioral and normative beliefs related to assessing the quality of foods and meeting family expectations respectively are the main beliefs factors affecting consumers’ packaged food purchase decisions in urban consumers.
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Contreras-Manzano A, Nieto C, Jáuregui A, Pérez Ferrer C, Vanderlee L, Barquera S, Sacks G, Adams J, Thrasher JF, Hammond D. Perceived Availability of Healthy and Unhealthy Foods in the Community, Work, and Higher Education Settings across Five Countries: Findings from the International Food Policy Study 2018. J Nutr 2022; 152:47S-56S. [PMID: 35544236 PMCID: PMC9188857 DOI: 10.1093/jn/nxac070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/11/2022] [Accepted: 03/15/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Food environments play a key role in dietary behavior and vary due to different contexts, regulations, and policies. OBJECTIVES This study aimed to characterize the perceived availability of healthy and unhealthy foods in 3 different settings in 5 countries. METHODS We analyzed data from the 2018 International Food Policy Study, a cross-sectional survey of adults (18-100 y, n = 22,824) from Australia, Canada, Mexico, the United Kingdom (UK), and the USA. Perceived availability of unhealthy (junk food and sugary drinks) and healthy foods (fruit or vegetables, healthy snacks, and water) in the community, workplace, and university settings were measured (i.e. not available, available for purchase, or available for free). Differences in perceived availability across countries were tested using adjusted multinomial logistic regression models. RESULTS Across countries, unhealthy foods were perceived as highly available in all settings; in university and work settings unhealthy foods were perceived as more available than healthy foods. Australia and Canada had the highest perceived availability of unhealthy foods (range 87.5-90.6% between categories), and the UK had the highest perceived availability of fruits and vegetables for purchase (89.3%) in the community. In university and work settings, Mexico had the highest perceived availability for purchase of unhealthy foods (range 69.9-84.9%). The USA and the UK had the highest perceived availability of fruits and vegetables for purchase (65.3-66.3%) or for free (21.2-22.8%) in the university. In the workplace, the UK had high perceived availability of fruits and vegetables for purchase (40.2%) or for free (18.5%), and the USA had the highest perceived availability of junk food for free (17.3%). CONCLUSIONS Across countries, unhealthy foods were perceived as highly available in all settings. Variability between countries may reflect differences in policies and regulations. Results underscore the need for the continuation and improvement of policy efforts to generate healthier food environments.
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Affiliation(s)
| | - Claudia Nieto
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Alejandra Jáuregui
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Carolina Pérez Ferrer
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico,National Council for Science and Technology, Mexico City, Mexico
| | - Lana Vanderlee
- École de Nutrition, Centre Nutrition, santé et société (Centre NUTRISS), and Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Gary Sacks
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Burwood Victoria, Geelong, Australia
| | - Jean Adams
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - James F Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - David Hammond
- School of Public Health and Sciences, University of Waterloo, Waterloo, Canada
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Nieto C, Jáuregui A, Contreras-Manzano A, Potvin Kent M, Sacks G, White CM, Pauzé E, Vanderlee L, Thrasher JF, Barquera S, Hammond D. Adults' Exposure to Unhealthy Food and Beverage Marketing: A Multi-Country Study in Australia, Canada, Mexico, the United Kingdom, and the United States. J Nutr 2022; 152:25S-34S. [PMID: 35544288 PMCID: PMC9188858 DOI: 10.1093/jn/nxab449] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/10/2021] [Accepted: 12/28/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Food marketing increases product appeal, purchasing, and consumption, using diverse strategies and locations to reach consumers. OBJECTIVES The aim of this study was to examine differences in adults' self-reported exposure to various marketing strategies (brand and licensed characters, celebrities, and sponsorship of sports and cultural events) and locations (television, radio, and digital media) across 5 countries: Australia, Canada, Mexico, the United Kingdom, and the United States. METHODS We analyzed cross-sectional survey data on self-reported exposure to food marketing strategies and locations collected in 2018 by the International Food Policy Study. Participants (n = 21,678) aged ≥18 years completed an online survey. Exposures to unhealthy food marketing strategies and locations in the prior 30 days were self-reported. Regression models examined differences in marketing exposure and locations across countries. RESULTS The average number of unhealthy food marketing strategies to which participants reported being exposed ranged from 0.5 in the United Kingdom to 2.3 in Mexico. Self-reported exposure to strategies across all countries was highest for brand characters (32%), followed by licensed characters (22%). In total, the reported mean exposure of marketing locations was 1.6 in the prior month. Television was the most prevalent location (44%), followed by digital marketing (32%). Adjusted models indicated that the odds of reporting exposure to marketing strategies and marketing locations were higher for Mexico compared to the rest of the countries. CONCLUSIONS Adults report a variety of exposures to unhealthy food marketing in all countries, but exposure was highest in Mexico. Special attention should be paid to regulating marketing strategies, such as brand characters and licensed characters, and locations, such as television and digital marketing.
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Affiliation(s)
- Claudia Nieto
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | | | | | - Monique Potvin Kent
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Gary Sacks
- Global Obesity Centre, Deakin University, Geelong, Australia
| | - Christine M White
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Elise Pauzé
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Lana Vanderlee
- École de Nutrition, Centre Nutrition, santé et société (Centre NUTRISS), and Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada
| | - James F Thrasher
- Arnold School of Public Health, University of South Carolina, South Carolina, USA,Center for Population Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
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Campos-Nonato I, Vargas Meza J, Nieto C, Ariza AC, Barquera S. Reducing Sodium Consumption in Mexico: A Strategy to Decrease the Morbidity and Mortality of Cardiovascular Diseases. Front Public Health 2022; 10:857818. [PMID: 35392467 PMCID: PMC8980680 DOI: 10.3389/fpubh.2022.857818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
Hypertension (HTN) and cardiovascular diseases (CVD) are important public health problems in Mexico. High sodium intake is linked to high blood pressure and increased risk of developing CVD. International organizations suggest consuming <2 g of sodium/day; however, the Mexican population consumes amounts above what is recommended: 3.1 g/day. Although efforts have been made to mitigate this problem, interventions are needed to improve cardiovascular health. This policy brief offers a short review of the current sodium consumption situation in Mexico and the importance of why decision makers should consider actions to reduce consumption. Recommendations to reduce sodium/salt intake include: Reformulation of ultra-processed-foods, promote the use warning labels, communication campaign, reduce the use of table salt, and monitor sodium intake.
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Affiliation(s)
- Ismael Campos-Nonato
- Research Center of Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Jorge Vargas Meza
- Research Center of Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Claudia Nieto
- Research Center of Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Ana Carolina Ariza
- Research Center of Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Simón Barquera
- Research Center of Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
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Contreras-Manzano A, Cruz-Casarrubias C, Munguía A, Jáuregui A, Vargas-Meza J, Nieto C, Tolentino-Mayo L, Barquera S. Evaluation of the Mexican warning label nutrient profile on food products marketed in Mexico in 2016 and 2017: A cross-sectional analysis. PLoS Med 2022; 19:e1003968. [PMID: 35442949 PMCID: PMC9067899 DOI: 10.1371/journal.pmed.1003968] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 05/04/2022] [Accepted: 03/16/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Different nutrient profiles (NPs) have been developed in Latin America to assess the nutritional quality of packaged food products. Recently, the Mexican NP was developed as part of the new warning label regulation implemented in 2020, considering 5 warning octagons (calories, sugar, sodium, saturated fats, and trans fats) and 2 warning rectangles (caffeine and non-nutritive sweeteners). The objective of this cross-sectional study was to evaluate the Mexican NP and other NPs proposed or used in Latin America against the Pan American Health Organization (PAHO) model. METHODS AND FINDINGS Nutrition content data of 38,872 packaged food products available in the Mexican market were collected in 2016 and 2017. The evaluation of the Mexican NP, including its 3 implementation phases of increasing stringency (2020, 2023, and 2025), was conducted by comparing the percentage of products classified as "healthy" (without warnings) or "less healthy" (with 1 or more warnings), as well as the number and type of warnings assigned to food products, against the PAHO NP. Using the calibration method, we compared the classifications produced by the PAHO model against those produced by the NP models of Ecuador, Chile (3 phases), Peru (2 phases), Uruguay, and Brazil. Kappa coefficients and Pearson correlations were estimated, and proportion tests were performed. We found that the 3 implementation phases of the Mexican NP had near to perfect agreement in the classification of healthy foods (Mexico NP models: 19.1% to 23.8%; PAHO model: 19.7%) and a strong correlation (>91.9%) with the PAHO model. Other NPs with high agreement with the PAHO model were the Ecuador (89.8%), Uruguay (82.5%), Chile Phase 3 (82.3%), and Peru Phase 2 (84.2%) NPs. In contrast, the Peru Phase 1, Brazil, and Chile Phase 1 NP models had the highest percentage of foods classified as healthy (49.2%, 47.1%, and 46.5%, respectively) and the lowest agreement with the PAHO model (69.9%, 69.3%, and 73%, respectively). Study limitations include that warnings considered by the Mexican NP models were evaluated as if all the warnings were octagon seals, while 2 out of the 7 were rectangular warnings (caffeine and non-nutritive sweeteners), and that our data are limited by the quality of the information reported in the list of ingredients and the nutrition facts table of the products. CONCLUSIONS The 3 implementation phases of the Mexican NP were useful to identify healthy food products. In contrast, the Peru Phase 1, Brazil, and Chile Phase 1 NP models may have limited usefulness for the classification of foods according to the content of ingredients of concern. The results of this study may inform countries seeking to adapt and evaluate existing NP models for use in population-specific applications.
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Affiliation(s)
- Alejandra Contreras-Manzano
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Carlos Cruz-Casarrubias
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Ana Munguía
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Alejandra Jáuregui
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Jorge Vargas-Meza
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Claudia Nieto
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Lizbeth Tolentino-Mayo
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Simón Barquera
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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Ríos V, Denova-Gutiérrez E, Barquera S. Association between living in municipalities with high crowding conditions and poverty and mortality from COVID-19 in Mexico. PLoS One 2022; 17:e0264137. [PMID: 35192660 PMCID: PMC8863291 DOI: 10.1371/journal.pone.0264137] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/03/2022] [Indexed: 12/15/2022] Open
Abstract
Background The World Health Organization stated a pandemic by severe acute respiratory syndrome coronavirus SARS-Cov2 (COVID-19) on March, 2020 with devastating implications for populations, healthcare systems, and economies globally. Objective The present study explores the association between patients living in municipalities with crowding conditions and poverty and mortality from COVID-19 in Mexico; specifically evaluating the socioeconomic characteristics of the municipality in which the patients reside and some individual characteristics. Methods In the present study, we examined public information collected from the National Epidemiological Surveillance System informing all persons tested for SARS-CoV-2 and published by the Ministry of Health. The present analysis was restricted to those with the date of registration to October 12, 2021. The association between the main exposures (overcrowded conditions and poverty) and the outcomes of interest (death by COVID-19) was explored using Cox proportional hazard regression models, including frailty penalties to accommodate multilevel data and random effects for the municipality of case occurrence. Results A total of 9619917 subjects were included in the Epidemiological Surveillance System for viral respiratory disease platform. Of those for which results were available, 6141403 were negative for COVID-19 and 3478514 were positive for COVID-19; with a total of 273216 deaths in those who tested positive. Among those positive to COVID-19 mean age was 46.9. Patients living in municipalities with high rates of crowding conditions increased the risk of dying from COVID-19 by 8% (95% CI: 1.03, 1.14). Individuals living in municipalities with indigenous background was associated with an increased risk of dying from COVID-19 (HR = 1.10; 95% CI: 1.04, 1.17). Individuals living in municipalities with illiteracy (HR = 1.09; 95% CI: 1.03, 1.11), poverty (HR = 1.17; 95% CI: 1.14, 1.19), food insecurity (HR = 1.094; 95% CI 1.02, 1.06), limited access to social security (HR = 1.10; 95% CI: 1.08, 1.13) and health services (HR = 1.06; 95% CI: 1.04, 1.08) had a higher risk of mortality from COVID-19. Conclusion Our data suggest that patients living in municipalities with higher rates of crowding conditions and higher rates of poverty had elevated risk of mortality from COVID-19. In Mexico, the COVID-19 pandemic is a systemic crisis linked to human development since we have seen that it affects less developed and more vulnerable municipalities. Policies to reduce vulnerabilities and develop strategies to deal with health crises like the current one needs to be considered.
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Affiliation(s)
| | - Edgar Denova-Gutiérrez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
- * E-mail:
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Barquera S, Véjar-Rentería LS, Aguilar-Salinas C, Garibay-Nieto N, García-García E, Bovecchio A, Perichart O, Torres-Tamayo M, Esquivias-Zavala H, Villalpando-Carrión S, García-Méndez RC, Apolinar-Jiménez E, Kaufer-Horwitz M, Martínez-Montañez OG, Fajardo Niquete I, Aguirre Crespo A, Gómez-Álvarez E, Hernández-Jiménez SC, Denova-Gutiérrez E, Batis C, Elías-López D, Palos-Lucio AG, Vásquez Garibay EM, Romero-Velarde E, Ortiz-Rodríguez MA, Almendra-Pegueros R, Contreras A, Nieto C, Hernández-Cordero S, Munguía A, Rojas-Russell M, Sánchez-Escobedo S, Delgado-Amézquita E, Aranda-González I, Cruz-Casarrubias C, Campos-Nonato I, García-Espino F, Martínez-Vázquez S, Arellano-Gómez LP, Caballero-Cantú I, Hunot Alexande C, Valero-Morales I, González-González L, Ríos-Cortázar V, Medina-García C, Argumedo G, Calleja Enríquez CR, Robles Macías E, Nava-González EJ, Lara-Riegos J, Sánchez-Plascencia AK, Hernández-Fernández M, Rodríguez Nuñez JL, Rangel-Quillo S, Cancino-Marentes ME, Hernández-Viana MJ, Saldivar-Frausto M, Alvarez-Ramirez M, Sandoval-Salazar C, Silva-Tinoco RO, Moreno-Villanueva M, Villarreal-Arce ME, Barriguete JA, White M, Jauregui A, Tolentino-Mayo L, López-Ridaura R, Rivera-Dommarco J. Volviéndonos mejores: necesidad de acción inmediata ante el reto de la obesidad. Una postura de profesionales de la salud. Salud Publica Mex 2022; 64:225-229. [DOI: 10.21149/13679] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 02/24/2022] [Indexed: 11/06/2022] Open
Abstract
La creciente epidemia de obesidad ha sido uno de los retos más importantes de salud pública en México durante los últimos años. Con apoyo de la Federación Mundial de Obesidad, en 2021 formamos un grupo de profesionales para identificar y resumir las acciones prioritarias en las que puede enfocarse nuestro país para hacer frente a esta epidemia. Al proceso de desarrollo y discusión de este grupo se sumaron más de 1 000 profesionales de la salud para retomar recomendaciones de documentos y guías de alto nivel previamente publicados. En conmemoración del Día Mundial de la Obesidad, en este 2022 se presenta esta postura como insumo para el desarrollo de acciones en el ámbito profesional y de los diferentes sectores, en la que se incluyen 10 recomendaciones de acción, desde la perspectiva poblacional hasta la atención individualizada, y se enfatiza en la importancia de la participación social, de las intervenciones integrales con visión centrada en la persona y de la sostenibilidad planetaria, además de mejorar la educación y las campañas de difusión, propiciar un ambiente promotor de entornos activos y blindar de conflictos de interés los esfuerzos de prevención y control. La postura hace un llamado para abordar la obesidad de manera seria, con base en la evidencia científica, oportuna e integral, con enfoque de curso de vida, de forma ética y sensible, y sin perpetuar las barreras del estigma de peso en la sociedad.
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Medina C, Monge A, Denova-Gutiérrez E, López-Ridaura R, Barquera S, Romieu I, Lajous M. Validity and reliability of the International Physical Activity Questionnaire (IPAQ) long-form in a subsample of female Mexican teachers. Salud Publica Mex 2022; 64:57-65. [PMID: 35438907 DOI: 10.21149/12889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/06/2021] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To evaluate the test-retest reliability and validity of the long-form International Physical Activity Questionnaire (IPAQ-long form). MATERIALS AND METHODS A subsample of 86 teachers underwent telephone interviews and clinic visits in Mexico City. Through 22 months, physical activity (PA) levels were obtained from accelerometers (months 6 and 22) and IPAQ long-form (months 1, 3, 6, 9 and 12). Minutes per week of moderate (MPA), walking (WPA), vigorous (VPA) and moderate-to-vigorous physical activity (MVPA) were calculated for each intensity and domain. Variables were loga-rithmically transformed. Intra-class and Pearson correlations were used to determine the relationship between instru-ments. RESULTS Test-retest reliability of the average IPAQs long-form varied across intensities and domains (ranged from r= 0.24 to r= 0.65). Minutes per week of VPA and MVPA ac-celerometer 1 (AC1) were fairly associated to International Physical Activity Questionnaire-long form 3 (IPAQ3) (r= 0.60 and r= 0.31, respectively) one week apart. CONCLUSIONS IPAQ long-form is fairly reliable for MVPA and valid for as-sessing MVPA and VPA in a subsample of Mexican teachers.
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Affiliation(s)
- Catalina Medina
- Center for Nutrition and Health Research, National Institute of Public Health. Mexico City, Mexico.
| | - Adriana Monge
- Center for Research on Population Health, National Institute of Public Health. Mexico City, Mexico.
| | - Edgar Denova-Gutiérrez
- Center for Nutrition and Health Research, National Institute of Public Health. Mexico City, Mexico.
| | - Ruy López-Ridaura
- National Center for Preventive Programs and Disease Control, Ministry of Health. Mexico City, Mexico.
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health. Mexico City, Mexico.
| | - Isabelle Romieu
- Section of Nutrition and Metabolism, International Agency for Research on Cancer. Lyon, France.
| | - Martín Lajous
- Center for Research on Population Health, National Institute of Public Health. Mexico City, Mexico/Department of Global Health and Population, Harvard University T.H. Chan School of Public Health. Boston, United States.
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